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Ventriculo-peritoneal shunt

 

If your child has a ventriculo-peritoneal shunt (VP shunt), you might have questions about it. Read about keeping your child safe with a VP shunt.

What is hydrocephalus?

Hydrocephalus is a condition that makes fluid build up inside the brain. The fluid is called cerebrospinal fluid, or CSF. Normally, this fluid drains by itself. But when your child has hydrocephalus, the fluid needs help to drain. Otherwise, the increased pressure can hurt your child’s brain or even be life threatening.

A VP shunt is one (1) way to treat hydrocephalus. It helps keep your child healthy by relieving the pressure in the brain.

What is a VP shunt?

A VP shunt is a long plastic tube that lets fluid drain from the brain to another part of the body. This keeps pressure from building up on the brain when your child has hydrocephalus.

ventriculo-peritoneal shunt

A VP shunt has at least 3 parts. They are:

  1. The ventricular catheter, the tube that goes into the brain,
  2. The valve, which controls the pressure in the brain, and
  3. The distal catheter, the tube that connects the other parts of the VP shunt to a space in the body. This is usually the abdominal (belly) cavity, also called the peritoneal cavity.

You might be able to feel the distal catheter behind your child’s ear. This tube runs down the neck into the belly area. The picture at the right shows a child with a VP shunt. The fluid flows through the tube from the brain to the belly cavity. Then the body soaks the fluid up. The fluid does not go into the stomach.

If your child has an external shunt

If your child’s shunt drains to a bag outside the body, he has a type of shunt called an “external shunt.” See “Do you know… External shunts.

If your child’s shunt can be programmed

Some VP shunts can be programmed and some cannot. If a shunt can be programmed, the doctor can adjust the amount of fluid it drains from your child’s brain. This lets the doctor adjust the pressure. So, it is important to know if your child has this type of shunt, called a “programmable shunt”. It needs to be checked and programmed every time your child has an MRI. If not, it will not work correctly. This could hurt your child.

What do I need to know about my child’s VP shunt?

If your child has a VP shunt, she usually depends on it for good health. The shunt must work well to keep pressure on the brain from rising. So you should know the warning signs that the shunt is not working well. Your child will probably show the same signs any time this happens.

Warning signs of a VP shunt not working properly

  • A headache that hurts more as time passes. Your child might act acts irritated (impatient, grouchy, whiny, or anxious). This might be the only sign of a headache if your child is young or cannot talk yet.
  • Vomiting (throwing up) with little or no nausea (feeling sick to her stomach).
  • Not as alert as normal – If you cannot wake your child, take her to the nearest emergency room right away or call 911.
  • Changes in personality – For example, a child who is easy to deal with becomes very hard to handle all of a sudden or "does not act right."
  • Skin swelling along the path of the VP shunt.
  • A bulging soft spot on your child’s head.
  • Vision problems – Such as blurry vision, double vision, or not being able to see.
  • Loss of some mental and physical abilities that she already mastered (milestones that fit your child’s age).
  • Trouble with balance or walking

These warning signs can happen quickly. For example, your child might seem fine one day, but the next day you might notice one (1) or more of these signs.

If you notice any of the warning signs above, call your child’s doctor right away, day or night. If you are in the Memphis area, call the doctor or nurse practitioner in your child’s primary clinic or the doctor on call at 595-3300. If you are outside the Memphis area, call your local neurosurgeon or doctor. If you are on a vacation, you should call 911 or go to the nearest emergency room and tell them that your child has a shunt that might not be working properly.

What is a shunt infection?

A shunt infection happens when bacteria get in the area around the VP shunt. When this happens, the shunt can stop working properly. This can let pressure build up in your child’s brain. The pressure can damage your child’s brain or even be life threatening.

To help your child stay healthy, you should know the 3 signs of a shunt infection.

Signs of a shunt infection

  • A fever of 100.4 degrees Fahrenheit or more (38.0 degrees Celsius)
  • Redness or swelling of the skin along the path of the VP shunt
  • Pain around the shunt or tubing

Please contact your child's doctor or nurse practitioner right away if you think something might be wrong with the VP shunt. If you are in the Memphis area, call your child’s St. Jude doctor at 595-3300. If you are outside the Memphis area, call your local doctor or neurosurgeon.

What else do I need to know about my child's VP shunt?

Know the name of the neurosurgeon in your area who will take care of the VP shunt if it is not working properly. A neurosurgeon is a doctor who does brain surgery. Call the neurosurgeon right away, if you see any signs of infection or the shunt not working properly.

Know the name of the VP shunt that your child has. Carry in your wallet a small copy of the MR image or CT scan that was done when your child’s shunt was working properly. The St. Jude Diagnostic Imaging staff can give you one of these cards. Ask your child’s St. Jude doctor or nurse practitioner about it.

What do I need to know about long-term care of my child’s VP shunt?

Children and teens with VP shunts usually need them for life.

The VP shunt can stop working properly or become infected at any time. You must always look for the warning signs of these problems.

Who must know that my child has a VP shunt?

  • Your child’s local neurosurgeon or doctor. The neurosurgeon needs to check the VP shunt at least one (1) time each year. This doctor will know what to do if the VP shunt stops working properly or the area around it gets infected.
    • If your child lives within 100 miles of Memphis, the pediatric neurosurgeons at Semmes-Murphy Clinic in Memphis will be happy to check the shunt. Call 901-522-7700 to make an appointment.
    • If your child lives more than 100 miles from Memphis, a neurosurgeon in your area should check your child’s VP shunt. St. Jude will give your child’s neurosurgeon a copy of the MR images or CT scans to keep on file. Talk with your child’s St. Jude doctor or nurse practitioner about this.
  • Emergency services workers: Your child should always wear a MedicAlert® bracelet or necklace. If your child is ever seriously hurt and needs medical help, this tells the emergency services workers that your child has a VP shunt. You can sign up for this type of bracelet or necklace at your local drug store. You can also visit www.medicalert.com to learn more.
  • Someone living with or near the patient: When your child grows up and leaves home, at least one (1) person living with your child or near them must know about the VP shunt. This could be a close friend, relative, co-worker, or neighbor. This person should learn the warning signs of a shunt that is not working properly. They should agree to watch for these signs and get medical help for your child quickly if they happen.

Remember that your child depends on the VP shunt. It must work properly so your child can stay healthy for life.

Questions?

To learn more about VP shunts, talk to your child’s St. Jude doctor or nurse practitioner. If you are inside the hospital, dial 3300. Locally, call 595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 when the call connects.


 

This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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