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Ventriculoperitoneal shunt - discharge

Your child has hydrocephalus and needed a shunt placed to drain excess fluid and relieve pressure in the brain. This buildup of brain and spinal cord fluid (cerebrospinal fluid, or CSF) and pressure causes the brain tissue to press (become compressed) against the skull. Too much pressure or pressure that is present too long can damage the brain tissue.

Your child had a cut (incision) behind the ear and a small hole drilled through the skull. A small cut was also made in the belly. A valve was placed underneath the skin behind the ear. One tube (catheter) was placed into the brain to bring the fluid to the valve. Another tube was connected to the valve and threaded underneath the skin down into your child's belly.

What to Expect at Home

Any stitches or staples that you can see will be taken out in about 7 to 14 days.

All parts of the shunt are underneath the skin. At first, the area at the top of the shunt may be raised up underneath the skin. As the swelling goes away and your child's hair grows back, there will be a small raised area about the size of a quarter that is usually not noticeable.

Self-care

DO NOT shower or shampoo your child's head until the stitches and staples have been taken out. Give your child a sponge bath instead. The wound should not soak in water until the skin is completely healed.

DO NOT push on the part of the shunt that you can feel or see underneath your child's skin behind the ear.

Your child should be able to eat normal foods after going home, unless the health care provider tells you otherwise.

Your child should be able to do most activities:

  • If you have a baby, handle your baby the way you would normally. It is OK to bounce your baby.
  • Older children can do most regular activities. Talk with your provider about contact sports.
  • Most of the time, your child may sleep in any position. But, check this with your provider as each child is different.

Your child may have some pain. Children under 4 years old may take acetaminophen (Tylenol). Children age 4 and older may be prescribed stronger pain medicines, if needed. Follow your provider's instructions or instructions on the medicine container, about how much medicine to give your child.

When to Call the Doctor

The major problems to watch for are an infected shunt and a blocked shunt.

Call your child's provider if your child has:

  • Confusion or seems less aware
  • Fever of 101°F (38.3°C) or higher
  • Pain in the belly that does not go away
  • Stiff neck or headache
  • No appetite or is not eating well
  • Veins on the head or scalp that look larger than they used to
  • Problems in school
  • Poor development or has lost a developmental skill previously attained
  • Become more cranky or irritable
  • Redness, swelling, bleeding, or increased discharge from the incision
  • Vomiting that does not go away
  • Sleep problems or is more sleepy than usual
  • High-pitched cry
  • Been looking more pale
  • A head that is growing larger
  • Bulging or tenderness in the soft spot at the top of the head
  • Swelling around the valve or around the tube going from the valve to their belly
  • A seizure

Alternative Names

Shunt - ventriculoperitoneal - discharge; VP shunt - discharge; Shunt revision - discharge; Hydrocephalus shunt placement - discharge

References

Blount JP. Ventricular shunting procedures. In: Winn RH, ed. Youmans Neurological Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 190.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 88.

Patient Instructions

Review Date 7/4/2016

Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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