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About Your Nonprogrammable VP Shunt for Pediatric Patients

This information will help you learn about your nonprogrammable ventriculoperitoneal (VP) shunt. For the rest of this resource, our use of the words “you” and “your” refers to you or your child.
 
A VP shunt is used to drain extra fluid that circulates around the brain and spinal cord. This fluid is called cerebrospinal fluid (CSF). It is found in the ventricles of the brain and the spinal canal. If too much CSF is in the ventricles, it puts pressure on the brain and skull (see Figure 1). This is called hydrocephalus.
 
Figure 1: Brain with and without hydrocephalus Figure 1: Brain with and without hydrocephalus
To help drain the extra CSF from the brain, a VP shunt is inserted into the head. The shunt takes the fluid out of the brain and moves it into the abdomen, where it is absorbed by the body. This decreases the pressure and swelling in the brain.
 
Figure 2: VP shunt Figure 2: VP shunt A VP shunt has 3 parts (see Figure 2):
 
  • A one-way valve and reservoir 
  • A short catheter (thin, flexible tube)
  • A long catheter 
The valve controls the flow of fluid. It is attached to the short catheter to drain the fluid away from your brain. The short catheter can be placed in the front, back, or side of your head. The long catheter is also attached to the valve. It is then tunneled under your skin, behind your ear, down your neck, and into your abdomen. 
 
As the VP shunt drains excess CSF and decreases the pressure in your brain, it may relieve your symptoms. Some symptoms will disappear immediately after the VP shunt is inserted. Others will go away more slowly, sometimes over a few weeks. 
 
Below are common questions that people have about a nonprogrammable VP shunt.
 

How will my nonprogrammable VP shunt be placed?

Your nonprogrammable VP shunt will be placed during surgery. Your nurse will give you more information about it.
 

What does “nonprogrammable” mean? 

The amount of fluid that is drained by your VP shunt depends on the pressure settings on your shunt. Your doctor will make these settings in advance. They cannot be changed. This is why it is a called a “nonprogrammable” VP shunt. 
 
Check the box next to the pressure setting of your nonprogrammable VP shunt below.
 
  • Low
  • Medium
  • High
Your nurse will also give you a wallet card that states you have hydrocephalus with a nonprogrammable VP shunt. Carry it with you at all times.
 

What precautions do I need to take if I have a nonprogrammable VP shunt?

MedicAlert® jewlery

You should always wear a MedicAlert® bracelet or necklace stating that you have hydrocephalus with a nonprogrammable VP shunt. If you are ever seriously ill or hurt and need medical help, this item will inform emergency services workers about your VP shunt. You can buy this type of bracelet or necklace at most drug stores. For more information, visit the MedicAlert® website at: www.medicalert.com
 
You do not need to take any precautions if you have magnetic resonance imaging (MRI), a computed tomography (CT) scan, or x-rays.
 

Abdominal surgery

If you ever need to have abdominal surgery, you must tell your neurosurgeon so that precautions can be taken. Tell your neurosurgeon if you have peritonitis or diverticulitis requiring emergency surgery or antibiotic treatment. 
 

Are there any restrictions on my activities?

You cannot participate in any contact (collision) sports (i.e., football, boxing, wrestling). You can participate in all noncontact sports (i.e., swimming, running). Remember to wear a helmet to decrease the risk of head injury, if needed. Ask your neurosurgeon for specific guidelines on wearing a helmet.
 

When should I call my doctor or nurse practitioner? 

Call your doctor or nurse practitioner if you are having any of the following signs and symptoms that your nonprogrammable shunt is not working properly: 
 
  • Vomiting with little or no nausea 
  • A constant, unrelieved headache 
  • Vision problems (blurry, double vision, or loss of vision)
  • Irritability
  • Fatigue
  • Personality changes 
  • Loss of coordination or balance
  • Swelling, redness, or both, along the shunt path
  • A bulging soft spot on an infant’s head
  • Difficulty waking up or staying awake 
  • Decrease in school performance 
Call your doctor or nurse practitioner if you are having signs and symptoms of a VP shunt infection. A VP shunt infection develops when bacteria infect the tissue around a VP shunt. When the tissue is infected, it can cause the VP shunt to stop working properly and increase pressure in the brain. The signs and symptoms of a VP shunt infection include: 
 
  • A temperature of 100.4° F (38° C) or higher
  • Redness, swelling, or both, of the skin that runs along the shunt path
  • Pain around the shunt or around the shunt tubing from the head to the abdomen 
These warning signs can appear quickly. If any of these symptoms develop, call your doctor or nurse practitioner immediately. 

If you cannot wake your child, call 911, or go to the nearest emergency room immediately.