Cerebral shunts are commonly used to treat hydrocephalus , the swelling of the brain due to excess buildup of cerebrospinal fluid(CSF). If left unchecked, the cerebral spinal fluid can build up leading to an increase in intracranial pressure(ICP) which can lead to intracranial hematoma , cerebral edema , crushed brain tissue or herniation. The cerebral shunt can be used to alleviate or prevent these problems in patients who suffer from hydrocephalus or other related diseases. Shunts can come in a variety of forms but all of them consist of a pump or drain connected to a long catheter, the end of which is usually placed in the stomach. The main differences between shunts are usually in the materials used to construct them, the types of pumps used, and whether the pump is programmable or not.
Types of Valves -Delta , Medium pressure cylindrical ,Nulsen & Spitz , Anti Siphon , Sigma .
The location of the shunt is determined by the neurosurgeon based on the type and location of the blockage causing hydrocephalus. All brain ventricles are candidates for shunting. The catheter is most commonly placed in the abdomen but other locations include the heart and lungs. Shunts can often be named after the route used by the neurosurgeon. Below are some common routing plans for cerebral shunts.
Ventriculo-Peritoneal shunt (VP Shunt) - Peritoneal Cavity
Ventriculo-Atrial Shunt (VA Shunt) -Right atrium of the heart
Ventriculo-Pleural Shunt (VPL Shunt)- Pleural Cavity
This procedure is done in the operating room under general anesthesia . It takes about 1 1/2 hours. The child's hair behind the ear is shaved off. A surgical cut in the shape of a horseshoe (U-shape) is made behind the ear. Another small surgical cut is made in the child's belly.A small hole is drilled in the skull. A small thin tube called a catheter is passed into a ventricle of the brain.
Another catheter is placed under the skin behind the ear and moved down the neck and chest, and usually into the abdominal (peritoneal) cavity.
A valve (fluid pump) is placed underneath the skin behind the ear. The valve is attached to both catheters. When extra pressure builds up around the brain, the valve opens, and excess fluid drains out of it into the belly or chest area. This helps decrease intracranial pressure. The valves in newer shunts can be programmed to drain more or less fluid from the brain.
Dr.Sanjay Mongia , Neurological Surgeon. Ph: 9821313033
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