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Lumbar Peritoneal Shunt
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Lumbar Peritoneal Shunt

  Hello.  My name is Kristine.  I am a 24 year old mother of two.  I was diagnosed with PsuedoTumor Cerebri (PTC) in Feb. of 1998.  Initially, I was tapped and
  the Nuerologist found a pressure of 590.  Additionally, my Opthomologist found extreme pappilldema.  My vision field in my right eye diminished to 25% vision field
  and the left eye sight diminished to 75% vision field.  The first course of action aside from the spinal tap was
  to try diamox.  Diamox caused ventricular tachycardia, so obviously that was stopped.  Next it was recommend that I be put on Lasix(which I have been on for
  about 10 months now) and it was recommended that I have Optic Nerve Fenestration done on both of my eyes.  The first surgeries were performed in June.  Since then
  I have continued to have multiple LP's, and both of the surgeries have failed.  Now as they say, I am on to bigger and better things, in this regard, I am referring to
  a Lumbar Peritoneal Shunt.  I have looked everywhere I can on the net to get info on this procedure.  I am looking for a brief step by step account onf the procedure.  
  Just something like: First we make an incision in the spinal the from there we us endosocpy to pull the tube around your side and into the admonial cavity.  Also I have a few
      1: How do they place they tube? Is it done with an entire insicion around my body or is it done Enodoscopicly?
      2: My doctor said I will have a spinal headache for about 10 days.  I assume that just as with the high pressure headache the spinal headache can't be treated with meds?
      3: How long do you typically have to stay in the hospital?
      4: The doctor said something about is being possible for the tube to catch my bladder and injure it?  Why is that possible?
  I appreciate they help that I have found here at this site.  I have felt very lost this past year not being able to find info on PTC etc.  Here I have found lots of people who
  are dealing with the same stuff as me.  Thanks!
Dear Kristine:
Sorry to hear about all of your problems with PTC.  Some surgeons do not use endoscopy to do this surgery.  Our neurosurgeon here at the Clinic uses endoscopy.  It all depends on the surgeons comfort level with what he/she has used in the past.  If your go to the library and look in a neurosurgury text, I am sure you will find this procedure.  Either way, you will likely not have a huge scar around your body.  The tube is placed from the lumbar spine into the abdominal cavity.  There is a valve that will open only when there is enough pressure by the CSF to drain off fluid.  This prevents over draining of fluid.  Although the surgeon talked about nicking the bladder, I am thinking he told you this only as a possibility that he/she tells all the patients as an adverse effect of surgery.  The possiblility of this occuring is very low.  I wouldn't think that you would have to stay in the hospital more than 3 or 4 days at most.  Unfortunately, spinal headaches can only be partially treated with medication.  When you sit or stand, the headache will happen and when you lie down the headache will go away.  Most of the pain will be controlled by the medication.  Best of luck with the surgery, let us know how it turns out.
CCF Neuro MD

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