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Hydrocephalus and shunts

hydrocephalus; hydro; cephalus; spina; bifida; shunt; blockage; Arnold; chiari; ventricles; meningitis; head; injury; valve; CFS; cerebral; spinal; fluid; learn; learning; behaviour;

Inside every brain there is a clear fluid called ‘cerebrospinal fluid’ (CSF). This fluid is made inside spaces in the brain, called ventricles. The CSF flows out over the surface of the brain and down the spinal cord before being absorbed into the bloodstream. CSF provides nutrients to the brain and spinal cord and removes waste products. It also acts as a cushion to protect the brain and spinal cord.

Hydrocephalus is when children too much CSF in the ventricles in their brain, and the ventricles get bigger and begin to cause problems.

Since the fluid is still being made by the brain, the build-up of CSF will cause pressure to rise inside the brain. This can then lead to signs of raised pressure and eventually damage to the brain, if not treated.

Contents

What is hydrocephalus?

Hydrocephalus is when children have too much CSF in the ventricles in their brain, and the ventricles get bigger and begin to cause problems.

There is more information about this in the Women’s and Children’s Hospital (South Australia) fact sheet ‘Your child and hydrocephalus’ including:

  • What causes hydrocephalus?
  • Do children with spina bifida often have hydrocephalus?
  • How is hydrocephalus diagnosed?
  • What are the signs of hydrocephalus?
  • How will hydrocephalus affect my child?
  • How is hydrocephalus treated?   

What is a shunt?

A shunt is used to treat hydrocephalus. A shunt is made up of two lengths of very fine soft tubing with a valve that sits between them. One tube goes into one of the ventricles in the brain. The other tube goes into the area where the CSF is dumped, usually the peritoneum (tummy). The valve usually sits behind the ear and controls the pressure. Once a certain pressure is reached some CSF will be drained from the ventricles to reduce the pressure.

There is more about this in the fact sheet ‘Your child’s shunt - general information’ – including:

  • What do I need to know about programmable shunt valves?
  • Can you see the shunt?
  • What can go wrong with the shunt?
  • How do I know if the shunt may not be working properly?
  • How likely is it that my child will have a seizure (fit)?
  • What should I do if my child has a seizure (fit)?
  • Where can I get support in South Australia? 

There is also more information about shunts in the Fact sheet ‘Your child’s shunt - Frequently Asked Questions’, including:

  • How long the shunt will last, when it will need extending, symptoms of the shunt not working, learning, food, travelling, telling others, playing sport, possible effects of injuries and other aspects of everyday living. 

Everyday living

It is normal that children with hydrocephalus will want to play both on their own and with other children, and your child should be treated the same as any child of the same age. There is information about lifestyle, exercise, sport, travel, school and activities away from home in the factsheets listed below.

Children with shunts should avoid contact sports, such as football or rugby, which may cause a head injury or damage the shunt. A helmet should be worn when bike riding, skateboarding or other sports where there is a risk of a head injury.

A First Aid Plan will tell those looking after your child about the signs to watch for that the shunt may not be working properly. It will also tell them what they need to do if they notice any of these signs. 

Sometimes when playing or during normal activity and sport, your child may fall over and /or hit his head. If this happens and you are concerned, you will need to call the hospital or see a doctor. If your child’s behaviour changes or they show any signs and symptoms that the shunt may not be working properly, you will need to seek urgent medical attention.

Signs that shunt may not be working

Signs for a baby - there may be one or more:

  • Irritable, unsettled
  • More sleepy than usual
  • High pitched cry
  • Vomiting
  • Sunsetting eyes (eyes unable to look up)
  • Poor feeding
  • Head getting bigger
  • Fontanelle (soft spot on top of the head) full and firm when sitting up and quiet
  • Seizures (fits)
  • Fever
  • Swelling/redness along shunt tract

Signs for a child- there may be one or more:

  • Irritable, confused, disorientated or just not usual self
  • More sleepy than usual
  • Headache
  • Vomiting
  • Double or blurred vision
  • Photophobia (eyes sensitive to light)
  • Unsteady on feet
  • Difficulty doing routine tasks
  • Seizures (fits)
  • Fever
  • Swelling/redness along shunt tract

If your child is showing one or more signs that the shunt may not be working properly or may be infected, take your child into your Hospital Emergency Department. If you are in a rural or remote area, take your child to the nearest emergency department.

In an emergency call 000 for an ambulance.

For more information

 Fact sheet ‘Your child’s shunt - general information’ in the section 'How do I know if the shunt may not be working properly?

Resource – South Australia

Women’s and Children’s Hospital
Department of Neurosurgery
72 King William Road
North Adelaide South Australia 5006
Telephone: (08) 81617230

http://www.wch.sa.gov.au/services/az/divisions/psurg/neuro/index.html  

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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