Used to treat hydrocephalus—a condition where an excessive amount of cerebrospinal fluid accumulates within the skull and puts dangerous pressure on the brain—ventriculoperitoneal shunting with a programmable valve relieves pressure on the brain by helping to drain the excess accumulation of cerebrospinal fluid. And because it utilizes a “programmable” valve, in the post-surgery phase physicians can control exactly how much cerebrospinal fluid is drained and confirm that the amount is optimal to prevent the need for future procedures.
A clear fluid that surrounds and protects both the brain and spinal cord from impacts and jarring, cerebrospinal fluid also acts as a transporter of nutrients down the spinal cord and well as a remover of waste and regulator of pressure on the brain—too much pressure, as in those suffering from hydrocephalus, can lead to permanent brain damage and death.
Occurring in all age and gender groups, hydrocephalus is classified into specific types: the “congenital” form is present at birth and arises from abnormal fetal development; “acquired” presents after birth and is the result of injury or disease; “communicating” occurs when cerebrospinal fluid is blocked after leaving the ventricles of the brain; “obstructive” means the cerebrospinal fluid can’t flow between ventricles; “normal pressure” (common with elderly patients) arises from trauma and hemorrhages, infections or tumors; and “ex-vacuo” is the result of a stroke or other trauma to the brain. And in terms of causes of hydrocephalus, genetic defects, traumas, strokes, hemorrhages, infections of the central nervous system and tumors of the brain and spinal cord can all lead to the condition.
Depending on how much cerebrospinal fluid is building up and what is causing the condition, symptoms can vary widely but often include nausea and vomiting; changes in mood or behavior; problems with memory and cognitive functions; balance and coordination issues; vision problems; headaches; and irritability.
With a patient under general anesthesia, a surgeon makes a small incision in the skull and inserts a catheter into the ventricular area of the brain. This is attached to the programmable valve while a second catheter is inserted into the abdomen, routed on a path under the skin and then also connected to the valve. The incisions are then sutured or stapled shut.
When too much pressure on the brain from excessive cerebrospinal fluid is detected, the valve opens and drains this fluid through the catheter and into the abdomen. And a physician assists patients in fine-tuning the device in order to determine the ideal pressure at which to open the adjustable valve.
Typically patients who have undergone a ventriculoperitoneal shunting with a programmable valve procedure can expect to remain in the hospital for at least a day for observation and monitoring. During the recovery phase headaches experienced while sitting up are possible and should be discussed with a physician immediately as they may indicate that the programmable valve requires adjustment.