What Is a Ventriculoperitoneal (VP) Shunt?

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A ventriculoperitoneal (VP) shunt is a device used to relieve excessive pressure on the brain. There are some serious situations in which the brain becomes in danger of physical compression due to pressure from fluid or blood. Excess fluid within one of the fluid-containing regions of the brain called the ventricles and/or the space surrounding the brain is called hydrocephalus.

Hydrocephalus can cause long-term consequences, and may be life threatening.

Hydrocephalus may produce an increase in intracranial pressure, which means high pressure within the skull. One of the ways to manage hydrocephalus is with a VP shunt, which redirects the fluid away from the brain and to another area of the body that can more easily tolerate surplus fluid.

A VP shunt needs to be put into place by means of a surgical procedure. If you have a VP shunt or if you are scheduled to have a VP shunt, then it would be beneficial for you to know some facts about VP shunts so you will know what to expect.

What Is a VP Shunt?

A VP shunt is a hollow tube with two openings, one on each end. One end of the tube is positioned underneath the skull, inside the ventricles.

The other end of the tube extends down through the body, with the opening positioned in the space that surrounds the abdominal region, which is called the peritoneum.

This connection between the ventricles of the brain and the abdominal peritoneum allows excess fluid to flow away from the brain and into the peritoneum, where it is not harmful and is actually absorbed by the body.

A VP shunt may also have valves that can be adjusted to modify the rate of fluid flow.

Why Would You Need a VP Shunt?

There are a number of medical conditions that can cause a buildup of excessive fluid inside or around the brain. The fluid may be blood or it may be cerebrospinal fluid (a watery, nutrient containing fluid that protects and nourishes the brain), or it may be a combination of both.

Because the brain is safely protected by the skull, there is not a route through which excess fluid can escape. Therefore, an overload of fluid physically pushes on the brain, potentially causing severe brain damage. In fact, too much fluid around the brain can even cause death if certain vital regions of the brain become compressed. These vital regions are primarily located in the brainstem and they moderate life-sustaining functions such as breathing, heart rhythm, and blood flow.

The function of a VP shunt is to allow an escape route for this dangerous accumulation of fluid or blood. There are a few different methods that can be used to relieve pressure around the brain. These methods include a lumbar puncture, a craniotomy (removal of part of the skull to allow space for the brain), and a VP shunt. Your situation may necessitate one or more of these methods to remove or relieve the excess pressure inside or around your brain.

There are a variety of conditions that may cause blood or cerebrospinal fluid to accumulate in the brain. These conditions include:

  • Head trauma causes bleeding and swelling.
  • Bleeding in the brain
  • Severe or large stroke causes swelling in the area of the stroke.
  • Hemorrhagic stroke causes blood accumulation in the brain.
  • Brain aneurysm or arteriovenous malformation (AVM) rupture causes blood accumulation in the brain.
  • Swelling of the brain (edema) may occur from fluid imbalance, overproduction of fluid, or slow reabsorption of fluid.
  • Malformation of the brain or spine may block the normal flow of cerebrospinal fluid throughout the brain and spinal cord.
  • Certain medications may result in excess fluid production or slow reabsorption of fluid.
  • Inflammation of the brain, spine or cerebrospinal fluid.
  • Brain infection (encephalitis) or infection of the meninges that protect the brain (meningitis)

How To Prepare for a VP Shunt and What To Expect

Placement of a VP shunt requires a procedure that involves brain surgery and surgery of the abdominal region.

You may have already had a VP shunt placed as an emergency due to rapidly worsening intracranial pressure. If you are scheduled to have a VP shunt, you are likely to have a series of pre-operative tests and you are going to be given instructions about when you can eat and drink in the days or hours before your surgery. In addition, you are likely to need someone to take you to the hospital and someone to take you home after the procedure.

If you have a VP shunt, you should be observant about headaches, weakness, or blurred vision and let your medical team know if you experience any of these symptoms. Your level of recommended physical activity might need to be somewhat adjusted so that the shunt can stay safe, secure, and clean.

Can a VP Shunt Cause Side Effects or Complications?

While it is not common, there are some complications that can occur with a VP shunt. The complications are:

  • Infection: This can occur if an infectious organism, such as bacteria, reaches any part of the shunt and spreads throughout the fluid.
  • Shunt obstruction/malfunction/blockage: A shunt can become twisted, or it may become blocked due to blood, an infection, inflammation, or the spread of cancer.

Is a VP Shunt Permanent?

Depending on the circumstances, a VP shunt can be temporary or permanent. If the cause of your hydrocephalus is idiopathic (unexplained), congenital (present from birth), or the result of a defect in the anatomy of the brain or spine, there is a strong chance that you will need to have your VP shunt for the long term.

However, if your VP shunt is placed for a sudden emergency, such as swelling from a stroke, an infection of the brain, or bleeding in the brain, then there is a high chance that your shunt can be removed once the cause of the swelling is resolved.

A Word From Verywell

A VP shunt is an important intervention used for serious situations that produce pressure on the brain. If you have a VP shunt or need a VP shunt, you need to maintain your medical follow-up to avoid complications so that you will recover as fully as possible.

Once you adjust to the regular maintenance of your shunt, you will learn to recognize any warning signs indicating that you need to get care for your shunt. If you are eventually able to have your VP shunt removed, you are likely to have a good recovery without long term issues related to your VP shunt.

Sources:

Bozhkov Y, Roessler K, Hore N, Buchfelder M, Brandner S, Neurological outcome and frequency of overdrainage in normal pressure hydrocephalus directly correlates with implanted ventriculo-peritoneal shunt valve type, Neurol Res. 2017 May 1:1-5.

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