shunt problems from hydrocephalus

[ZsMom]

My 8 year-old son was having occasional headaches and sometimes with vomiting.  They never lasted long and after a nap, he felt fine.  He had a routine ct scan which showed hydrocephalus.  Because he was not sick and only had headache symptoms, they did a spinal tap to see if a shunt was necessary.  His pressure was 33.  They did the shunt surgery and he is still having headaches and occasional vomiting.  The headaches do not last long as before and after resting, feels great.  I'm not convinced he had to have the surgery since it did not seem to solve the problem.  No one seems to know what causes the headache or what to do.  They did an adjustment of his pressure from 150 to 130 in September but that didn't seem to help.  Now they are saying headaches may be caused from low blood sugar?????  He has had no tests done for that.  Headaches can be at any time of the day although not usually at night.  He has had other xrays and ct scans since surgery and all come back normal.  I don't know what my next step should be or who to see.  Also, since the shunt surgery, he is occasionally hearing an echo in his right ear.  No one seems to have heard of that either.  I have looked online for echos and get nothing.

[selmaS]

I found this in wikapedia...hope it helps.

Shunt complications
Examples of possible complications include shunt malfunction, shunt failure, and shunt infection. Although a shunt generally works well, it may stop working if it disconnects, becomes blocked (clogged), infected, or it is outgrown. If this happens the cerebrospinal fluid will begin to accumulate again and a number of physical symptoms will develop (headaches, nausea, vomiting, photophobia/light sensitivity), some extremely serious, like seizures. The shunt failure rate is also relatively high (some sources cite up to 45% chance of shunt failure in the first year following placement)[citation needed] and it is not uncommon for patients to have multiple shunt revisions within their lifetime.

The diagnosis of cerebrospinal fluid buildup is complex and requires specialist expertise.

Another complication can occur when CSF drains more rapidly than it is produced by the choroid plexus, causing symptoms -listlessness, severe headaches, irritability, light sensitivity, auditory hyperesthesia (sound sensitivity), nausea, vomiting, dizziness, vertigo, migraines, seizures, a change in personality, weakness in the arms or legs, strabismus, and double vision - to appear when the patient is vertical. If the patient lies down, the symptoms usually vanish in a short amount of time. A CT scan may or may not show any change in ventricle size, particularly if the patient has a history of slit-like ventricles. Difficulty in diagnosing overdrainage can make treatment of this complication particularly frustrating for patients and their families.

Resistance to traditional analgesic pharmacological therapy may also be a sign of shunt overdrainage or failure. Diagnosis of the particular complication usually depends on when the symptoms appear - that is, whether symptoms occur when the patient is upright or in a prone position, with the head at roughly the same level as the feet.

Good luck
Godspeed
"selma"

[DrNoopurMD]

Hi,

Thanks for writing in.
It is important to do shunt surgery in patients with hydrocephalus as there are many complications of raised intracranial pressure which can cause brain damage.
Headaches do occur after shunt surgery and can indicate infections, and blockade of shunt. Since these possibilities have been ruled out and the shunt seems to be functioning well, other causes like you mentioned low blood sugar need to be looked at. It is important to make sure that he is well hydrated at all times and eats regularly and on time to prevent dehydration and low blood sugar. Take care!