How is It To Live With a VP Shunt

VP Shunt, also known as a ventriculoperitoneal shunt, is a medical device used to relieve pressure on the brain caused by fluid accumulation. A VP shunt is used to treat a condition called hydrocephalus. This condition is characterised by an accumulation of excess cerebrospinal fluid (CSF) in the brain's ventricles. CSF cushions your brain and protects it from any kind of injury.

It also delivers nutrients to the brain and removes waste products. When the normal flow of CSF in the brain is disrupted, the fluid begins to build up, exerting harmful pressure on brain tissue and leading to brain damage. Through surgery, a VP shunt is placed into one of the brain's ventricles to divert cerebrospinal fluid away from the brain and restore normal flow and pressure.

Causes of Hydrocephalus

Blockage in the normal flow of cerebrospinal fluid (CSF) in the brain
Brain tumors or cysts that obstruct CSF pathways
Brain infections such as meningitis
Brain inflammation or bleeding in the brain
Congenital abnormalities affecting CSF circulation
Head injuries or complications after brain surgery

Symptoms of Hydrocephalus

Persistent headaches
Nausea and vomiting
Excessive sleepiness or fatigue
Poor coordination and balance problems
Memory loss or cognitive difficulties
Vision problems
Irritability and mood changes
Enlarged head size in infants
Loss of bladder control

VP Shunt Surgical Procedure

The surgery is performed under general anesthesia in an operating room.
A small incision is made behind the ear, and a tiny opening is created in the skull.
A thin catheter is inserted into the brain's ventricle to drain excess cerebrospinal fluid.
A valve is connected to regulate the flow of the fluid.
Another catheter is passed under the skin through the neck and chest to the abdominal cavity.
The excess fluid is then absorbed by the body in the abdomen.

Post-Operative Recovery after VP Shunt Placement

After surgery, most patients will remain in the hospital for a period of time as determined by the surgeon, generally a few days for monitoring purposes.
Imaging studies (CT scans) may be performed at any time postoperatively to confirm the shunt's position.
Immediately following surgery, many patients will experience mild headaches, fatigue, and tenderness at the incision sites.
Patients are instructed to rest, gradually return to their regular activities within one week, and avoid any type of head impact activity (e.g., sports) for approximately six weeks.
Patients will require regular follow-up appointments to assess shunt function and monitor their overall recovery.

Living with a VP Shunt and some of the most Frequently Asked Questions (FAQ)

Q. What is the normal life with a VP shunt?

Most of the patients with hydrocephalus need to retain their shunt for their whole life. The major advantage of this therapy is the restoration of a normal daily life. The VP shunt will regulate CSF flow. You and your family may be required to participate in surveillance after a VP shunt procedure. Your doctor will recommend post-operative precautions and regular medical check-ups to detect any possible complications.

Q. Is it possible to practice sports with a VP Shunt?

You can practice sports after this procedure like any normal person. However, you should avoid violent activities that could cause the device to be shocked and damage the valve mechanism or pressure settings.

Q. Can I get pregnant with a VP Shunt?

Getting pregnant is not contraindicated in case you have a VP shunt. However, before you plan your pregnancy, it is important to discuss it with your neurosurgeon.

Q. Is it okay to travel with a VP Shunt?

Yes, you can travel normally with a VP shunt. The magnetic fields generated by airport security doors should not affect your valve's pressure setting. However, do carry your Patient Identification Card with you at all times. This is a card provided to you by your neurosurgeon after shunt surgery.

Q. Can I drive with a VP shunt?

It is recommended that patients not drive for six months after the VP shunt procedure. Even after 6 months, most patients only find out when they have high-pressure headaches. In such cases, driving should be avoided until shunt malfunctioning is ruled out or the symptoms resolve.

Q. Do I need to take any precautions with the adjustable valve?

Adjustable valves are insensitive to most everyday magnetic fields, such as those from airport security doors, microwave ovens, mobile phones, high-tension wires, and TVs. They do not affect the pressure settings of your valves. However, the permanent magnets in smartphones, toys, audio headphones, and loudspeakers, and the electromagnetic fields generated by the electric motor in shavers, hair dryers, and clippers can modify the pressure settings in the adjustable valves. Hence, to avoid any risk of pressure changes, these devices must not be brought too close to the valve site.

Q. Do I need to carry any particular document?

Yes, you need to keep the Patient Identification Card (PIC) with you at all times. This card is provided by your neurosurgeon and contains information about the implanted device (reference, setting, etc.), which is important for your medical follow-up.

Q. When do I need to consult my doctor?

You should consult your doctor in case you experience a headache, vomiting, visual or hearing problems, sleepiness, walking difficulties, unexplained fever, redness, edema, any skin abnormality, or any other issue.

Q. Can I undergo an MRI exam with a valve?

A patient who has been fitted with a fixed-pressure valve may undergo an MRI exam without risk or special supervision. However, a patient with an adjustable pressure valve might need special supervision during an MRI exam. The pressure settings of the valves must be checked regularly before and after exposure to the MRI.

Conclusion

VP shunts have been a lifesaver for countless people worldwide. Candidates with hydrocephalus require a VP shunt for life and need to replace it from time to time. However, this does not ensure the device's functionality and efficiency; as with any other device, the shunts are also subject to malfunction. If the device starts functioning abnormally, the candidate will experience a recurrence of previous symptoms, along with additional symptoms. A malfunctioning VP Shunt can be seen as redness at the site where the shunt has been placed. The candidate can also note the painful sensation.

Besides, the candidate's cognitive performance will also be recognised in this case. Apart from these, common symptoms that should not be ignored include persistent headaches, vomiting, nausea, loss of appetite, dizziness, confusion, and others. However, VP shunt anomalies are rare. This is also why candidates are advised to opt for authorised clinics and multi-speciality hospitals, as well as successful VP shunt surgeons, to increase the chances of success.