Re: shunted child

Posted By Lynne on March 03, 1999 at 12:51:33:

In Reply to: Re: shunted child posted by CCF Neuro[P] MD, RPS on February 26, 1999 at 11:59:13:






I posted a message a few days ago regarding CSF pressure.  Your response leads me to my next question.  As I told you, my child was shunted as a toddler for extraaxial fluid collections that have since resolved (subduroperitoneal shunt).  Her ventricles are and have always been within normal limits.  At six yrs. of age, her subdural shunt was converted to a VP due to elevated opening pressure discovered during a scheduled revision.  I wonder if you know what the long term effects on her brain might be - normal ventricles with  a VP shunt.  She suffers daily headaches since the conversion.  Thank you for any information.





Dear Lynn:
There should be no long term effects of the VP shunt other than what the possible sequalae might bring about.  By this I mean such things and shunt malfunction, infection, seizure activity, etc.  One cannot predict whether these things might happen, although they all are a possibility.  Some children have all of the possibilities and some have none, so prediction is really impossible.  Without doing a physical exam, it is impossible to tell you what the headaches are from.  I would let the surgeon and pediatric neurologist know about this and defer the cause to them.  I hope that your daughter suffers none of the possible complications.
Sincerely,
CCF Neuro[P] MD
My daughter has been seen by a pediatric neurologist and the cause of her headaches can't really be defined.  The best reason the Dr. could give us was that our child is dependent on a shunt she really does not need and is suffering from low pressure headaches.  The reason we feel she is shunt dependent is that she has shown unmistakable symptoms of elevated pressure (severe headache, nausea, vomiting, lethargy) on two occasions since her conversion from a subduroperitoneal to a VP shunt a year ago.  She required a revision both times.  Have you any experience with cases like hers.  If so, have you been able to successfully remove a shunt from a brain that is seemingly dependent on that shunt?  Our child's CT scans have never shown any evidence of hydrocephalus or abnormal ventricles.  Though we have an exceptional neurosurgeon now who is following our daughter closely, we remain interested in any additional opinions and ideas concerning this matter.  Thank you for any help you can offer.