Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Subject: Re: Lumbar Peritoneal Shunt
Forum: The Neurology and Neurosurgery Forum
Topic Area: Hydrocephalus
Posted by CCF NSG MD /gsh on August 10, 1998 at 19:43:34:
In Reply to: Lumbar Peritoneal Shunt posted by Maureen Akins on August 08, 1998 at 11:10:23:



Dear Sir,
My brother had surgery for a meningioma, followed by a very large suberacnoid haemorrhage four months ago, since then he has been paralysed in both arms and legs, he also has hydrocephalus, with herniation of the brain, he has no bone flap. Three days ago he was fitted with a Lumbar Peritoneal shunt, hoping this will show some improvement, in his memory loss, and paralysis, i cannot find any information on this type of shunt and its effectiveness. I would be so grateful if you could post to me any information you have on this type of shunt.
Thank you so much.
Maureen.


Dear Maureen,

First, it isn't clear why your brother has hydrocephalus. Hydrocephalus may be due to obstructive causes that physically block the flow of spinal fluid out of the brain, like tumors or blood in the ventricles. It can also be due to non-obstructive causes that block the outflow of spinal fluid into the venous system, like clogging a drain. Blood from a subarachnoid bleed can do this, as can infections. Which is the case here is not too clear.

Second, a subarachnoid hemorrhage is not usually associated with the removal of a meningioma. Subarachnoid hemorrhages are typically from aneurysms or arterio-venous malformations (AVM's) that have bled.

It is difficult to assess your brother's situation as it may be due to a combination of the entities discussed above. Hydrocephalus may be treated with a shunt from the head into the abdomen (ventriculo-peritoneal, or VP), or they maybe treated with a shunt from the back into the abdomen (lumbo-peritoneal, or LP). LP shunts have a higher incidence of failure in the literature, though either may be adequate if functioning properly.

Speak to your brother's surgeon for some clear answers as to his neurological condition and the reasons for it. Specifically ask about the subarachnoid bleed and why it occurred. You may be confused after getting all this information at once. Lastly, ask the surgeon why the LP shunt was chosen over a standard VP shunt. He will likely be happy to provide some clear answers.

Good luck.


[Neurology Forum]      [Neurology Forum Archives]