Brain hydrocephalus surgery in Türkiye (Ventriculoperitoneal Shunt)

What is brain hydrocephalus surgery?

Brain hydrocephalus surgery involves the placement of a small device called a Ventriculoperitoneal Shunt (VP), which is a medical device that relieves pressure on the brain caused by the accumulation of fluids.

Brain hydrocephalus surgery in Türkiye (Ventriculoperitoneal Shunt)

Brain hydrocephalus surgery is a surgical procedure primarily used to treat a condition called hydrocephalus. This condition occurs when excess cerebrospinal fluid accumulates in the brain’s ventricles.

Cerebrospinal fluid (CSF) surrounds and protects the brain from injury within the skull. It acts as a delivery system for nutrients your brain needs and also removes waste products. Typically, CSF flows through these ventricles to the base of the brain. It then washes the brain and spinal cord before being reabsorbed into the bloodstream.

When this natural flow is disrupted, the accumulation of fluid can lead to harmful pressure on the brain tissues, potentially causing brain damage. Surgeons place VP shunts inside one of the brain’s ventricles to divert the fluids away from the brain, restore the natural flow, and promote waste absorption.

Who needs the surgery?

Brain hydrocephalus can affect people of all ages and may require a VP shunt. However, it is more likely to occur in children and the elderly. It is estimated that 1-2 out of every 1000 infants are born with hydrocephalus.

The excess fluid can accumulate around the brain due to several reasons, including:

Overproduction of cerebrospinal fluid.
Impaired absorption of cerebrospinal fluid by blood vessels.
Blockage preventing fluid flow throughout the brain.

Blockage is the most common cause of hydrocephalus. Abscesses, tumors, or infections in the brain can obstruct the natural flow of cerebrospinal fluid, leading to unsafe accumulation. Symptoms of hydrocephalus may include:

Enlarged head size.
Headaches.
Seizures.
Irritability.
Excessive sleepiness.
Urinary incontinence.
Poor appetite.
Cognitive delay or regression.
Memory loss.
Poor coordination.
Visual impairment.

Imaging tests, such as ultrasound, CT scans, and MRI, help doctors diagnose hydrocephalus by visualizing the brain’s cavities and tissues. The tests show whether specific brain areas contain more fluid than usual.

Ventriculoperitoneal Shunt Procedure (Brain Hydrocephalus Surgery)

Doctors typically place a VP shunt while the patient is under general anesthesia. The patient will be asleep during the surgery and will not experience pain. The entire procedure takes approximately 90 minutes.

Discuss any food and drink restrictions with your doctor before the surgery. Older children and adults may need to fast for at least eight hours before the hydrocephalus surgery.

Infants and young children may only need to stop consuming formula and solid foods for six hours before the surgery but can usually drink water up to four hours before the scheduled procedure. In all cases, these instructions should be reviewed with the surgical team.

A surgical nurse will shave the area behind your ear in preparation for the VP shunt placement, where they will insert the catheter. Catheters are thin and flexible tubes used to drain excess fluids. The surgeon will make a small incision behind the ear and also drill a small hole in the skull. They will then thread one catheter into the brain through this opening.

The other catheter will be placed behind your ear and under the skin, meaning it will be beneath the skin. This tube will lead to the chest and abdomen, allowing excess cerebrospinal fluid to drain into the abdominal cavity, where the body can reabsorb it.

The surgeon may attach a small pump to the catheter and place it under the skin behind the ear. The pump will automatically activate to remove fluids when pressure increases in the skull. The pump, also called a valve, may be programmable.

Please note that this information is for general understanding, and it’s always essential to consult with a qualified medical professional for specific medical advice and personalized treatment plans.

Recovery Stage

Recovery from the VP shunt placement takes three to four days. Most people can leave the hospital within seven days after the procedure.

During your hospital stay, the medical team will monitor your heart rate and blood pressure, and your doctor will administer prophylactic antibiotics. Your doctor will ensure that the shunt is functioning properly before you leave.

Risks of Brain Hydrocephalus Surgery

VP shunt placement is a highly safe procedure. However, complications can occur during or after the procedure. Risks associated with any surgical procedure include excessive bleeding and infection.

You may also experience adverse reactions to anesthesia, such as breathing difficulties or changes in heart rate or blood pressure.

There are rare risks specific to brain hydrocephalus surgery that can be serious and life-threatening if left untreated, including:

Infections in the shunt or brain.
Blood clots.
Bleeding in the brain.
Brain tissue damage.
Brain swelling.

Fever, headache, abdominal pain, fatigue, elevated blood pressure levels, or the recurrence of symptoms present during the initial shunt placement may indicate an infection or malfunction in the shunt.

Inform your doctor immediately if you experience these signs and symptoms. Infections are more common in the first few weeks after shunt placement.

Recovery Stage

Recovery from the VP shunt placement takes three to four days. Most people can leave the hospital within seven days after the procedure.

Risks of Brain Hydrocephalus Surgery

VP shunt placement is a highly safe procedure. However, complications can occur during or after the procedure. Risks associated with any surgical procedure include excessive bleeding and infection.

You may also experience adverse reactions to anesthesia, such as breathing difficulties or changes in heart rate or blood pressure.

There are rare risks specific to brain hydrocephalus surgery that can be serious and life-threatening if left untreated, including:

Infections in the shunt or brain.
Blood clots.
Bleeding in the brain.
Brain tissue damage.
Brain swelling.

Inform your doctor immediately if you experience these signs and symptoms. Infections are more common in the first few weeks after shunt placement.

Success Rate of Brain Hydrocephalus Surgery

Brain hydrocephalus surgery (Ventriculoperitoneal Shunt) is successful in reducing brain pressure in most people. VP shunts are likely to require replacement after several years, especially in young children.

The average lifespan of an infant shunt is two years. Adults and children over two years of age may not need shunt replacement for eight years or more. Shunt systems require frequent monitoring and follow-up.

Complications that may occur with shunt systems include:

Mechanical malfunctions.
Obstructions in the shunt’s function.
Infections.

Malfunctions can lead to serious complications, such as overdraining or underdraining of cerebrospinal fluid. Overdraining occurs when the cerebrospinal fluid is drained from the ventricles at a faster rate than it is produced.

This can lead to ventricular collapse, causing headaches or bleeding inside the brain. Underdraining allows cerebrospinal fluid to accumulate on the brain and can cause symptoms of hydrocephalus. Seek immediate medical care if you experience symptoms indicating that the shunt system is not functioning correctly.