When you have a shunt for hydrocephalus, the amount drained off the brain is very important. The valve controls the amount of CSF (cerebrospinal fluild) drained from the brain. Having a valve that drains too little fluid from the brain, can cause the patient to lose their patience with their neurosurgeon.
The neurosurgeon may order any number of tests to check the shunt out. An ICP or Intracranial Pressure test can prove quite beneficial. It allows the doctor to see how much fluidic pressure is within the skull. "Normally" our brains produce around 500ml of CSF. Notice, I said "normally". Each of us are different though. Add onto that a person that who is diagnosed with hydrocephalus and you have an overproduction of CSF. The valve that allows the drainage of CSF into either the peritoneum (abdominal cavity), the superior vena cava (heart) or rarely the lumbar region (LP).
Some neurosurgeons who do not have enough experience with either the patient or hydrocephalus may tend to err on the side of under-draining. Though under-draining is uncomfortable for the patient. It is preferred to over-drainage. But, we will get into over drainage issues in another blog posting.
Even though a shunt is placed, the low setting on the valve does not allow enough CSF fluid to be drained off. So, the patient is still uncomfortable. They still feel as though their head is full of CSF fluid. Nausea, vomiting, dizziness, lack of balance and coordination, etc can be symptoms that the settings are still in need of an adjustment or a totally different valve if it is a fixed rate valve. That means; yet another operation. Yuck.
Neurosurgeons don't like to operate on an individual, too often; if they don't have to. The reason is quite simple. The neurosurgeon knows that each time they open someone up there are risks. When dealing with hydrocephalus, extreme risk. Some individuals can go quite a long time between operations. Then there are others that need to be seen by their neurosurgeon more often. That can be both stressful on the patient and family members. A very strong support network is extremely important.
The younger the patient, the easier to get others involved in "helping out". Yet, when you get to be an adult, sometimes the lack of family connections can be an added stressor. So, it's always good to keep in touch with someone regarding your (or your child's) hydrocephalus.
In conclusion; having a valve the drains too little fluid from the brain can cause the patient to lose their patience with their neurosurgeon.
Useful links:
http://www.depuy.com/patients-and-caregivers/rheumatoid-arthritis/hydrocephalus/congenital-acquired
http://www.medtronic.com/health-consumers/hydrocephalus/living-with/index.htm
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