05/01/2026
Hydrocephalus and VP- shunt
Hydrocephalus is a condition in which there is excess cerebrospinal fluid (CSF)(ICP > 40 mmHg(normal 5-15mmHg) in the brain’s ventricles, causing them to enlarge and potentially increase intracranial pressure.
🧠 What is Hydrocephalus?
Normally, CSF:
Is produced in the ventricles(choroid plexus)
Circulates around the brain and spinal cord
Gets absorbed into the bloodstream
Hydrocephalus occurs when there is:
1. Obstruction to CSF flow (Non-communicating / obstructive)
2. Impaired absorption (Communicating)
3. Rarely, overproduction
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🔎 Causes
In infants:
Congenital aqueductal stenosis
Neural tube defects (e.g., spina bifida)
Intraventricular hemorrhage (especially preterm babies)
In older children/adults:
Brain tumors
Meningitis
Subarachnoid hemorrhage
Head injury
In elderly:
Normal Pressure Hydrocephalus (NPH)
⚠️ Symptoms
In infants:
Enlarged head
Bulging fontanelle
Irritability
Vomiting
“Sunset” eyes
In adults:
Headache
Vomiting
Blurred vision
Gait disturbance
Memory problems
Classic NPH triad:
Gait disturbance
Urinary incontinence
Dementia
(“Wet, Wobbly, Wacky”)
🛠 VP Shunt (Ventriculoperitoneal Shunt)
A VP shunt is the most common surgical treatment for hydrocephalus.
What it does:
A thin tube (shunt) is inserted into a brain ventricle
Connected to a valve system
Drains excess CSF into the peritoneal cavity (abdomen)
CSF is then absorbed into the bloodstream
⚙️ Components of a VP Shunt:
1. Ventricular catheter
2. Valve (controls flow)
3. Distal catheter (to abdomen)
🚨 Complications of VP Shunt:
Infection
Blockage
Over-drainage (subdural hematoma)
Under-drainage
Shunt malfunction
📌 Other Treatment Options:
Endoscopic Third Ventriculostomy (ETV) (especially in obstructive hydrocephalus)
EVD(Eternal Ventricular Drain)
Ventriculoatrial (VA) shunt
Ventriculopleural shunt
-shunt
