How will I live a CSF shunt? (FAQ)

Most hydrocephalic patients will be required to keep their CSF shunt for the rest of their lives but one of the advantages of this therapy is that it allows you to have a normal daily life. The shunt will restore the CSF circulation to regulate its flow. Your condition will be monitored and surveyed continually by your medical team. Both you and your family will be required to participate actively in this surveillance. Post-operative precautions need to be taken and regular medical consultations are recommended in order to detect possible complications as early as possible.

The valve is most of the time implanted under the skin, behind the ear. Thus, it is harldy visible.

Yes. This is quite frequent. However, whatever the disturbance it may cause, it also means that the shunt is functioning well. The noise is due to the rotation of the ruby ball on its seat and the turbulence induced by CSF flow through the rigid structure of the valve. These noises are amplified and transmitted by the skull to the cochlea. These noises mainly occur when the patient is changing position leading to a temporary increase of the CSF flow through the shunt.

Adjustable valves are insensitive to the influence of everyday magnetic fields. This includes magnetic fields generated by airport security doors, microwave ovens, mobile phones, high tension wire and TV amongst others. So exposure to any of these should not affect the pressure setting. The permanent magnets (domestics, in smartphones, in toys, in tablets, in audio headphones and loudspeakers amongst others) and electromagnetic fields created by electric motors (shavers, hairdryers, clippers etc.) while turned on, can modify the pressure setting. To prevent any risk of pressure alteration, they must not be brought close to the valve site (less than 3cm from the valve). Exposure to a strong magnetic or electromagnetic field can alter the pressure setting.

Yes, you can practice sport. However, you should avoid all activities exposing the device to shocks (contact sports such as rugby, etc.) that may be likely to damage valve mechanism and cause unintentional changes of the pressure setting. In case of shock, you should always have the pressure setting of your valve checked by a neurosurgeon.

Pregnancy is not contraindicated if you have a shunt. However, it is necessary to discuss this project with your neurosurgeon.

The valve is designed to work for a lifetime, though sometimes some complications can occur. – Obstruction: this can cause the valve to stop working. It can either be the valve itself that is blocked by blood or CSF or the catheter that has disconnected or got obstructed in the same way as the valve can be. – Infection: an infection can occur around the valve implantion location. There are some symptoms like: fever, redness, swelling, etc. – Overdrainage: the valve can sometimes let too much CSF flow, which can be solved by regulating the flow pressure.

If you experience headaches, vomiting, visual or hearing disorders, sleepiness, walking difficulties or psychomotor wane, if you have a prolonged, unexplained fever, redness, oedema, or a skin anomaly along the course of the shunt, contact your surgeon immediately. Even if the risk of shunt complication is low, you and your family need to know that certain complications may arise after the operation. The main complications of shunts are obstruction, infection, and over-drainage. These complications require prompt attention by the patient’s physician.

If the valve is not functional, you will most likely get some of these symptoms: – Fever – Walking troubles – Vomiting – Headaches – Blurred vision – Nausea There is a yearly control to check the good functioning of your shunt in any event.

Adjustable valves are made so that the pressure setting can be adjusted regarding the needs of the patient, including their age. The size of the valve suits children and adults. Moreover the catheter length is adapted so the child can grow with it and avoid another intervention.

Yes, you can travel with a shunt. The magnetic fields generated by airport security doors should not affect the pressure setting of your valve. However, it is important to keep your Patient Identification Card with you at all times. This Patient Identification Card is provided by your neurosurgeon after your shunt surgery

There is no restrictions but ask you nureusurgeon to make sure that everything is in order. There should no problem for you to get on a plane.

No, the magnetic field of the detector is lower than the valve’s (0.37 mT vs 40 mT). Thus, there is no reason for your valve to make alarms go on.

Yes, you must keep your Patient Identification Card (PIC) with you. It provides information concerning the implanted device (reference, pressure setting etc.) which is important and necessary for your medical follow-up.

A fixed pressure valve has only one pressure available that must be chosen prior to the implantation. Adjustable valves, however, can be adjusted post operation, regarding the evolution of the flow.

A patient fitted with a fixed pressure valve may undergo an MRI examination without danger or special surveillance. A patient fitted with an adjustable pressure valve will need special surveillance during MRI. The pressure settings of the valve must be checked routinely before and after exposure to MRI or a powerful magnetic field. A patient fitted with an adjustable pressure valve which is MRI-stable does not need special surveillance during MRI, as long as the patient remains immobile in the immediate proximity and inside the MRI tunnel.

You are likely to feel a slight discomfort during the MRI examination, but it is not painful.

No such case have ever been reported. It could only happen if the magnetic field of the magnet is higher than 40 mT. For your information, magnetic fields for average devices are not powerful enough to affect the adjustment of the valve: – Hair dryer: 2 mT – Hoover: 0.8 mT – Microwave: 0.3 mT – Mobile phone: 0.01 mT – Induction cooker: 0.03 mT In case of any doubt, the patient should move away from the product, keep the valve far from the magnet (3 cm at least) and should not be exposed too long to the magnet.

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