Brain & Spine Shunting Procedures
A ventriculoperitoneal shunt (VPS) is a surgical treatment for hydrocephalus.
A shunt is a narrow tube used to drain the extra cerebrospinal fluid from the brain. Brain and spine shunting procedures are quite complicated, but if an experienced surgeon does this, a patient should not worry. There are different kinds of shunts for various body parts, but ventriculoperitoneal shunts are used for the brain and spine.
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Ventriculo-Peritoneal Shunt
A ventriculoperitoneal shunt (VPS) is a surgical treatment for hydrocephalus. Hydrocephalus is a neurological disease, literally meaning water on the brain, and can be very disabling.
This fluid (cerebrospinal fluid or CSF) is usually made and then reabsorbed at certain rates, and when these rates are not balanced, it can lead to an increase in the fluid, causing pressure and resulting in neurologic symptoms.
CSF normally resides in cavities in the brain called ventricles. The purpose of a VPS is to drain this excess fluid from the ventricle.
This is achieved by placing a tube into the ventricle (in the brain), which drains the fluid to the abdomen. There is typically a valve that prevents the fluid from moving in the wrong direction and only lets fluid drain when the pressure is too high.
Frequently Asked Questions about
Brain & Spine Shunting
The goal of a ventriculoperitoneal shunt (VPS) is to reduce the abnormally high pressure inside the brain. This is achieved by placing a catheter in the brain that allows the drainage of excess fluid into the abdomen.
The patient goes to sleep with general anesthesia. A small hole is made in the skull on the top of the head, behind the hairline. A small catheter is directed into the fluid-filled cavity in the brain (ventricle). Tubing is tunneled to a place behind the ear where a valve is placed to regulate fluid flow.
Tubing is again tunneled down to the belly (peritoneum), where the fluid can drain freely and be absorbed by the body. Brain shunting usually takes around an hour and a half to perform.
The significant risks of the procedure are bleeding, infection, damage to normal brain tissue, and the need for future operation. The risk of bleeding is immediate and will be detected while the patient is still in the hospital.
Major surgery may be required to prevent brain damage if excessive bleeding occurs. When the shunt is placed, the catheter must pass through normal brain tissue to reach the fluid cavity (ventricle).
The shunt is usually placed in a part of the brain that can tolerate this manipulation, but rarely can patients develop weakness, sensory or visual changes, and speech difficulty.
The risk of infection and obstruction is the most common problem with VPS. The shunt tubing is a foreign object in the body, making it impossible for the body to kill the bacteria growing on the tubing.
If the brain and spine shunt becomes infected, it needs to be removed and replaced with an entirely new system. If an obstruction occurs, only the part of the shunt system that does not work needs to be replaced.
Dr. Baker performs every surgery perfectly, from spine shunting to artificial disk replacement.
The success rates depend on the age of the patient and the reason why the shunt is needed. Generally, there is around a 50% failure rate for ventriculoperitoneal shunts. The shunt tubing can become infected or obstructed, requiring surgical revision.
Endoscopic third ventriculostomy (ETV) is an alternative treatment with a higher success rate but is only available for select patients (see endoscopic third ventriculostomy).
Patients can go home 2-7 days after surgery, depending on the clinical situation.
Dr. Baker specializes in neurosurgery, neurosurgical spine surgery, neurotrauma, brain tumors, spinal tumors, and peripheral nerve damage treatment.