LP Shunt Question

[Neon8RN]

I posted a similar question previously but noone answered, so I am trying again.

I had an LP shunt placed in April 2008 due to Intracranial Hypertension (aka Pseudotumor Cerebri). It worked great for a few months, but since then, has been over draining. The LP shunt I have is a one piece silicone-like tube with slit valves on the end. The valve is non-programmable, thus it seems to let off too much spinal fluid because the pressure is not regulated.

So, I am going to need a revision to my LP shunt. My neurosurgeon wants to place a programmable valve on the shunt. Has anyone experienced this - an LP shunt revision to place a programmable valve? How do they determine what the setting should be? How long were you in the hospital for the revision? How long until you can return to work? Have you had any problems since the programmable valve was placed?

Can you share your experiences with me?

[sasha63]

I was diagnosed with IH and had an lp shunt placed 11 years ago. I have started having severe headaches that I wake up with. Also,very alarming to me,is my memory. I am very disorientated and can't remember from one minute to the next where I put things. I have no insurance so I went to the ER. They seem to never heard of someone having an lp shunt,not a vp shunt. They did a CT of my brain and said it looked fine. They also did an xray to check my shunt.They said that was ok. Later,I looked at my chart online and it said,possible narrowing and kinking of my shunt.Also,the radiologist said the tubing was running out of my thoracic spine. What the heck? Could the kinking cause this horrible headache and disorientation and memory issues. I am pretty scared,Need some advice.

[becky433]

my dr. said my vent. had collapsed around the shunt valve in the brain like when you suck on a straw and there is something stuck in the other end and you just keep sucking until the straw collapses in on itself. Also he said that i could be rejecting the shunt but when we do the lp shunt we will be leaving in the vp shunt which does not make alot of sense but i am not a dr. the dr will not take me off my diamox or my topamax. i would ask to be put back on at least one of them because you have to have help to get rid of the fluid. unless you are on lasix. any fluid pill will help. what setting is you shunt set on?  right now i have my headaches and vomiting and dizzy and vision are just as bad as before i was ever diagnosed 7 years ago. i hope this helps. let me know.    

[Cath278]

   Neon8RN,  I was going to answer but the good Dr has answered your question perfectly!

becky433.I am so sorry to hear of the mess you are in. Can you tell me why your shunt is not working?
I am in a similar position as you.
I have a VP shunt, which works but it seems I produce too much csf for it to cope with.I also now have collapsed ventricles.
I am in a bit of a no mans land , right now, with no one quite sure what to do next.
I have been off Diamox since last year as they thought i was having rebound headaches from it.
My last  spinal tap  was, 340. Still way too high. Do you still have symptoms?

What a mess this illness is!  Cath278

[becky433]

l have had three vp shunts and now my ventricles have collapses and now I am to have a lp shunt placed in a couple of weeks. My spinal tap was 270. Also I am on Diamox and Topamax. I have been diagnosed with pseudotumor cerebrae for 7 years and have had migraines it seems all of my life. If this does not work what else can they do? I am a mother and would like to be able to have a life with my child and my husband.

[Dr_Veena]

Hi,
     Thanks for writing in. When you've been diagnosed with Intracranial Hypertension (IH) the treatment options you encounter will be slightly varied depending on your doctor and the severity of your condition. Some patients may initially receive serial Lumbar Punctures (LP's) to remove the excess Cerebral Spinal Fluid (CSF). In addition, you will likely be placed on medication as well. If you do not respond to these medications, and continue to have problems; other treatment options like optic nerve sheath fenestration and shunts can be considered.

A shunt is a device that is inserted in the body to move the spinal fluid from one place to another, where it can be re-absorbed. With LP shunts the tubing may be slit, which provides it's own built-in valve. This can lead to problems of over-draining in LP shunts. There are chances of low-pressure headaches and additional symptoms as in your case. Because the shunt creates a "suction" action, this may also lead to herniation of the tonsils of the brain over time (Chiari Malformation).

In some cases, revision of the shunt may be necessary. This can be caused by kinked tubing or overdraining. In case of over draining a valve may be attached to the shunt tubing. It controls the direction the cerebrospinal fluid flows and helps to regulate the amount of cerebrospinal fluid in the ventricles. The valve prevents the ventricles from over-draining, which is called over-shunting.
Consult your neurologist for further assistance.
Best.