5-Minute Emergency Consult

Ventricular Peritoneal Shunts

Description

  • Ventricular peritoneal (VP) shunts are usually placed for hydrocephalus.
    • Conduit between cerebrospinal fluid (CSF) and peritoneal cavity
  • Obstruction: Shunt malfunction impairs drainage of CSF:
    • Increases intracranial pressure (ICP)
    • Rate of increase in ICP determines severity.
  • Overdrainage syndrome:
    • Upright posture increases CSF outflow
    • Decreases ICP
    • Produces headache, as after lumbar puncture
  • Infection:
    • Shunt is a foreign body.
    • Staphylococcus epidermidis and other Staph. species in 75% of infections
    • Gram-negative organisms also implicated
    • Multidrug-resistant Staph. aureus (MRSA) has been reported.
    • Most occur within weeks of placement
  • Slit ventricle syndrome:
    • Prolonged overdrainage causes decreased ventricular size.
    • Intermittent increases in ICP occur owing to proximal obstruction.

Pediatric Considerations
  • Complications more common in children, especially neonates
  • If cranial sutures are open, CSF may accumulate without much ICP increase.
  • Produces relatively nonspecific signs and symptoms
    • Drowsiness, headache, and vomiting are the commonest symptoms

Ventricular Peritoneal Shunts has been found in 5-Minute Emergency Consult

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