VP Shunt malfunction

[plcman]

My wife had a VP shunt for 15 years with no real issues after a brain tumor (this is all clear now), a year ago she had issues with the shunt, the shunt was removed and replaced but failed within hours due to bleeding, the shunt was removed and an external drain fitted for several days to clear the bleed. When all was clear it was decided that a shunt was not required and she was discharged. During the year her health deteriated and in september a new shunt was fitted, for a few weeks her health improved vastly but then she began to go downhill again until she was back in hospitel at Xmas, the shunt was replaced and she was ok for a few days but now is back in hospital and worse than ever, CT and Xrays all look normal and last week she had an ICP monitor in for 4 days but the doctors say this looks ok and they do not suspect the shunt and are looking to give her more drugs and discharge her, she has the following symptoms:
Bad headache, feeling sick, loss of balance, worse vision, fatigue, tightening of the shunt pipe in neck (this is only since last revision). When she was laid down on the ICP monitor she felt better but when she got up and started to move around the symptoms got much worse. When i was with her during the ICP monitoring the pressures were all over the place, sometimes a minus figure and sometimes up near 40 so in my mnd this is not normal. Several neurologists have looked at her and all have said she needs to be seen by doctors, the doctors do not really seem interested and have no suggestions.
While i am no medical expert i am an engineer and the fluid principals here are similar i think. Everytime the shunt is revised fluid i guess is released and after the surgery my wife feels great for a few days but then starts to get the symptoms back again.
Any ides would be appreciated.
Age 41.
Andy

[plcman]

Thanks for your reply, strangely i was reading about this on the web last night and it sounds a feasible and a relatively simple proceedure (even though is brain surgery). The big issue i have is that 3 surgeons are convinced the issues are not related to the shunt, i must dissagree. They all seem intent on passing her onto a neurologist, if it were only headaches or nausia then i could perhaps believe this but there are too many pointers towards a faulty shunt.
I also spent several hours reading about the proGAV shunt system with anti syphon valve, this sounds like another viable option, do you have any experience of this shunt or any other adjustable valve system.
Do you know of or can recommend any centres or surgeon in the UK who specialise in this field?

Regards

Andy

[Dr Sharma]

Hi there.  It is principally fluid dynamics, the fluid here being cerebrospinal fluid.  She had hydrocephalus after tumor surgery, which required repetitive VP shunts to release which would block again and then same process again. The VP shunt drain can get blocked at the lower end usually due to movement or bloodclot and the pressure is transmitted up to the proximal end which causes CSF pressure to rise causing hydrocephalus. Your surgeon could  try doing a third ventriculostomy for better results. Hope this helps. Consult your neurosurgeon for that. Take care.