VENTRICULOPERITONEAL SHUNT

[cdm787]

I am a 49 year old male with a peritoneal ventricular shunt to relieve pressure from hydrocephalus brought on (most likely) by blood in the CSF after earlier NURO surgery live in Austin Texas,  when I travel I sometimes get bad headaches.  I take 10-20mg of Hydrocodone at 4-6 hrs (max 100) mg a day but even that does not touch these headache at all.  My question is this from all you know about shunts can elevation changes cause sufficient difference as in releasing to much fluid leaving me with a low pressure headache and if so how long before cranial pressure would normalize?  
Thank You
Dale.

[CCF-Neuro-M.D.-JT]

Sorry for the long wait. I did an extensive literature search and spoke to other colleagues here at the Clinic to see if any of their patients with shunts ever complained of similar problems. The consensus was this: technically, the altitudinal changes within an airplane shouldn't affect the CSF pressure or shunt system. Now you can certainly build up pressure behind your eardrums (within a closed system that is not part of the CSF flow) which is a common phenomenon. Also, if you have migraine headaches, altitudinal changes can certainly bring on or exacerbate them.

This is an interesting question and if I come across something to the contrary, I will let you know in a comment on the string.

[Gina_Marie87]

A related discussion, Can I fly overseas with a cerebral shunt? was started.

[klevi]

A related discussion, Flying with a shunt? was started.

[jody48]

A related discussion, VP Shunt Side Effect? was started.

[crickett73]

A related discussion, activities was started.

[gj11]

I had a VP shunt fitted 6 months ago and flew for the first time last week. Take off was fine, but landing caused a severe headache. I called a friend from the airport in a panic, who is a Dr and she was not sure what could be the cause. I had a LP shunt previously and flew with that many times without any trouble, but the flight last week has made me cautious about flying again. I was serching to see if there was any information regarding flying and VP shunts and I found this disscussion. There may be no medical reason for the headache that Doctors are aware of, but they are a very real problem to those of us with VP shunts.

[gj11]

I had a VP shunt fitted 6 months ago and flew for the first time last week. Take off was fine, but landing caused a severe headache. I called a friend from the airport in a panic, who is a Dr and she was not sure what could be the cause. I had a LP shunt previously and flew with that many times without any trouble, but the flight last week has made me cautious about flying again. I was serching to see if there was any information regarding flying and VP shunts and I found this disscussion. There may be no medical reason for the headache that Doctors are aware of, but they are a very real problem to those of us with VP shunts.

[Terry7]

I am a ex-neuro surgical, cardiac ICU Nurse, now in administration...My husband had a VP shunt for adult hydrocephalus. He has one left sided-working shunt and one right sided, non-working shunt (which was left in)...We have just arrived home from a lengthy missionary trip from New York to Ghana, Africa which required us to land at London, Ghana, back to London and then back to JFK in NYC.  

First, he triggered the metal detectors in all the airports...When wanded, it was his head...??? any metal in the shunts???

Second, all 4 landings caused him severe head pain...which we were monitoring very closely....(we almost turned back with the first landing in London)...he said "no" "we go on, maybe by camel?"...The pain started as a dull ache immediately at the DESCENT of the plane..lasting until we leveled off for landing...as the severe, overall pain went away, he reported it settle in the "middle of the right side of his head and made his right eyeball feel like it was going to pop out of his head"...Again, these occurrences were only at the DESCENT of the plane...The next 3 landings were all over his head, generally.  We are home now, but am watching him quite closely and he is going to see his neurosurgeon next week...who basically yesterday told me he had "never heard of anyone having problems with these"..."it must be sinus"...On the other hand, the neurologist wanted more info and was thinking barometric pressure changes would/could result in pressure changes on the shunt causing it to react?? He also wants more info...

MY QUESTIONS:

1.  Anyone who has responded....perhaps these are all the same types of shunts, inserted same time frame, bad batch etc, etc? Do you know what kind?

2.  I rationalized this out as Kit1 has noted...My water bottles got all "scrunched up" and I envisioned the shunts doing the same thing...they are softer, more pliable than water bottles???

3.  Has any neurologist or neurosurgeon checked for "pressure studies" on the types of plastics used?

4.  Has any neurologist or neurosurgeon done a study with their implant patients to see if there are more out there with this problem...? This should be upfront and noted so that patients do not have to suffer the consequences of an unknown entity that has not been studied thoroughly.  

Will keep all posted with the follow-ups and am praying my husband's shunts will be fine.

Terry7  

[Terry7]

I am a ex-neuro surgical, cardiac ICU Nurse, now in administration...My husband had a VP shunt for adult hydrocephalus. He has one left sided-working shunt and one right sided, non-working shunt (which was left in)...We have just arrived home from a lengthy missionary trip from New York to Ghana, Africa which required us to land at London, Ghana, back to London and then back to JFK in NYC.  

First, he triggered the metal detectors in all the airports...When wanded, it was his head...??? any metal in the shunts???

Second, all 4 landings caused him severe head pain...which we were monitoring very closely....(we almost turned back with the first landing in London)...he said "no" "we go on, maybe by camel?"...The pain started as a dull ache immediately at the DESCENT of the plane..lasting until we leveled off for landing...as the severe, overall pain went away, he reported it settle in the "middle of the right side of his head and made his right eyeball feel like it was going to pop out of his head"...Again, these occurrences were only at the DESCENT of the plane...The next 3 landings were all over his head, generally.  We are home now, but am watching him quite closely and he is going to see his neurosurgeon next week...who basically yesterday told me he had "never heard of anyone having problems with these"..."it must be sinus"...On the other hand, the neurologist wanted more info and was thinking barometric pressure changes would/could result in pressure changes on the shunt causing it to react?? He also wants more info...

MY QUESTIONS:

1.  Anyone who has responded....perhaps these are all the same types of shunts, inserted same time frame, bad batch etc, etc? Do you know what kind?

2.  I rationalized this out as Kit1 has noted...My water bottles got all "scrunched up" and I envisioned the shunts doing the same thing...they are softer, more pliable than water bottles???

3.  Has any neurologist or neurosurgeon checked for "pressure studies" on the types of plastics used?

4.  Has any neurologist or neurosurgeon done a study with their implant patients to see if there are more out there with this problem...? This should be upfront and noted so that patients do not have to suffer the consequences of an unknown entity that has not been studied thoroughly.  

Will keep all posted with the follow-ups and am praying my husband's shunts will be fine.

Terry7  

[cdm787]

FYI . . .   I did return driving thru the mountains and this time did not experience the severe kind of headache that I had the first time. I am scheduled to fly into New Mexico in August and I am a little concerned about a greater change in altitude there. If anyone has an idea where I could get more information on this please let me know.  I will check back on this string for a while.

Thank you again.
DM

[cdm787]

I (or my wife) will post again if something happens this time.
I realize it is hard to give an opnion when the data is so scarce. Under the circumstances I would have risked another trip anyway. I finally found my former neurosurgeon who concurs with your assessment. .  .

Thanks,
dm

[cdm787]

SHUNTED! !  NOW SHUNNED! ! ! help

[cdm787]

I guess the doctors are scared of this one. I have not flown since my surgery, but I do know what you are talking about.
Under other circumstances I would just stay home. My problem is this ... My sister like me has Hep C.  Hers turned into liver cancer. She is in her last few weeks if not days. The last time I went out to see her I had problems and my wife is very concerned about me going again. I am between Doctors right now and was hoping to get some idea from this site.

Thanks

[snowgoer]

My son who is now 19 had a VP shunt placed when he was born for hydrocephalus related to Spina bifida. I found your post interesting because of the only 2 times his shunt has malfunctunctioned, both times he developed symptoms within days of flying. (We have only flown 4 times too!) When I asked his neurosurgeons if there was any relation they said no because the cabins themselves were pressurized, but I found it hard to believe because it was too great a coincidence in my view. Will be interested in seeing if any further posts crop up regarding this.

[Kit1]

If you have taken a water bottle onto a plane you may have observed that the cabin pressure is a bit lower than normal atmospheric pressure. When you first open the bottle on the plane it lets out a puff of air, and as the plane lands, you can watch the bottle collapse slightly as the cabin pressure rises to equalize with the outside.

So even though the cabin is safely pressurized for breathing, it is low pressure compared to daily life.