My 37 year old daughter has had a ventricular shunt placed for pseudotumor, which malfunctioned. It was replaced with another ventricular shunt that was not working very well, with high csf pressures on LP, so a lumbar shunt was placed. Now at her last LP, her pressure is low. She goes to Mayo and they pretty much have washed their hands of this whole issue. The neurosurgeon says he has done his part, the shunt is working (too well) and the neurologist says "have you tried acupuncture?". I am not a brain surgeon, not even a doctor, but can't they figure out how to bring the pressure up so that she can have her life back?
Thank you for your question. Although without being able to examine her I can not offer you the specific advice on diagnosis and treatment that she needs, but I would try to provide you some relevant information about her health concern.
Generally, possible causes of continuous symptoms related to shunt may be either it is under-draining or over-draining. Her doctor can assess this with a lumbar puncture and measures the fluid pressure. He/She may make some adjustment of the shunt to allow it to drain more and can monitor if the symptoms improve. Another possibility could be shunt is over-draining, that may lead to low CSF pressure that can also lead to headache. This may improve when the person lies down and gets worse when the person sits or stands. Even then if she suffers continuous symptoms, please arrange an appointment with a neurologist right away who will evaluate the further underlying disorders here that may be the main reasons of her symptoms and can suggest her appropriate treatment. Hope this information proves helpful to you.
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