Ventriculo-Peritoneal Shunts

Some people have too much spinal fluid inside the skull (Figure 1). This condition is called “hydrocephalus.” Hydrocephalus can develop slowly with aging or may be present from birth. Having too much spinal fluid inside the skull can cause abnormal pressure on the brain, leading to headaches, dizziness, difficulty walking, memory issues, urinary incontinence and/or visual problems. The surgical solution to this problem is called a “shunt” (Figure 2). A shunt is a sterile plastic tube that drains excess spinal fluid out of the fluid spaces, or “ventricles,” of the brain and into the abdomen, or “peritoneum,’ where the excess spinal fluid can be absorbed more easily. A ventriculoperitoneal shunt is a completely implanted device under the skin that usually stays implanted for the duration of a patient’s life unless hydrocephalus spontaneously resolves, which is rare.

Figure1 - Hydrocephalus:
Figure 1

Figure 2 - Ventriculoperitoneal shunt:
Figure 2

Pseudotumor cerebri is another condition that is treated with a ventriculoperitoneal shunt. In pseudotumor cerebri, there is abnormally high pressure inside the skull, which causes symptoms like headaches, dizziness, and visual loss, which can progress to total blindness. Although this disease can occasionally be treated successfully with medication, surgery is indicated if there is evidence of progressive visual loss. A shunt decreases the amount of spinal fluid in the brain, thereby reducing the overall pressure inside the skull and improving symptoms.