All About VP Shunt Surgery

What is a VP Shunt?

A VP Shunt is a medical device used to help divert excess spinal fluid from around the brain into the abdomen where it can be reabsorbed.

To get a bit more technical, VP is short for “Ventriculo-Peritoneal”. The shunt is inserted into the “ventricles” or cavities of the brain where the CSF (cerebral-spinal fluid) is then transferred to the “peritoneal” (abdominal) region of the body.

There are also LP (lumboperitoneal – lumbar to abdomen) and VA (ventriculoatrial – head to heart) Shunts.

Why a VP Shunt?

VP Shunts are found to often be an effective treatment when there is excess fluid on the brain, usually due to conditions such as Hydrocephalus or Intracranial Hypertension.

In my particular case of Intracranial Hypertension, the VP Shunt was a bit of a last resort (as invasive procedures usually are). Medications and weight loss had failed, and I was not a candidate for a stent since no stenosis was present.

My Procedure

In preparation for my VP Shunt, my head was shaved in multiple spots but mainly behind my right ear. Most of this was done prior to pre-op.

I was completely unconscious for the entire surgery. I do not even remember entering the surgical room.

During surgery however, my head was presumably placed in some sort of “vice grip”, something that ended up leaving a small scar on my forehead.

An incision, approximately two inches in length, was made into the skin over my skull behind my right ear.

A device was then inserted through my skull into the cavities of my brain with a catheter going down my neck and sternum into my abdomen and pelvic area. There were three smaller incisions made on my abdomen for this part of the procedure.

Recovering from VP Shunt Surgery

The day of surgery, I was not in any major pain (though obviously still medicated). I actually experienced more pain and cramping in my abdomen than in my head. This is likely from CO2 insufflation during the abdominal part of my surgery. 

I was discharged from the hospital the very next day and experienced horrendous pain in my head that night, despite pain killers.

I was given antibiotics to take for only a couple of days and painkillers to take as needed.

I was instructed to keep the wound clean and to apply ointment morning and night. I could not get it wet for the first several weeks.

I was able to sleep on a pillow immediately, something I was determined to get used to early on.

For the first eight weeks of recovery, I was not allowed to lift anything over 10 lb. I was also not allowed to swim or submerge myself in water.

I had a two week follow-up as well as an eight-week follow-up where I was released of my limitations.

Near the incision site, my head remained numb for many months, gradually fading away till I could feel it again. It does not hurt to touch the area, but it does hurt to firmly push into it.

The shunt is not visible beneath my hair. The device protrudes about as much as my clavicle does, a small bony-feeling bump about two inches long.

Because my intracranial pressure still had high moments, my shunt required adjustments during this time due to “under drainage”. Although my neurosurgery team disagreed, thankfully my neurologist spoke up.

Abdominal pain and cramping remained even two years later. This presents itself in two ways: 1.) Something similar to “gas cramps” in my pelvic region and 2.) Sharp stabbing pains near my abdominal incision. Additional tests have found no issues, and it can be assumed this is just my body’s way of reacting to the foreign matter within.

Shaving Your Head

I was not required to shave my head for this surgery. Although some places on my head were already shaved, it is possible they could have been covered up with hair.

However, I chose to shave my head (the day I returned home) because I could not stand the thought of having one more thing to deal with or to get in my way. My hair was very long and thick and at this point completely matted with dried blood from surgery. I felt recovery would be much simpler if I had it out of the way altogether. It’s just hair after all. It grows back.

And although I had purchased beanies (chemo caps) to wear, I realized it would only interfere with the ointment and healing of my head.

My neurologist only suggested that I keep the area clear from the sun, as another patient of his had damaged their shunt from a bad sunburn.

VP Shunt Surgery Results

In the end, my VP Shunt Surgery was not a complete success like we had hoped.

Due to “under-drainage”, shunt adjustments had to be made even months later, and medications are still required even years later to help keep my system balanced.

It is also possible to “overdrain” and cause episodes of Intracranial Hypotension if I take too many diuretics on top of what my shunt is already draining.

Overall, the VP Shunt helps with gradual changes in my pressure. However, if there are any sudden or drastic spikes, it can be too much for my shunt to drain at once. Therefore, pressure can still build.

Regardless of everything I have been through, I have no regrets.