Complications

More long term complications are associated with VA shunts than with VP ones although in the short term - the first three months, the reverse may be true. Consequently, VP shunts are becoming more popular.

The major complications include:

• infection
• blockage
• chronic subdural haematoma - due to collapse of the ventricles pulling the cortical surface from the dura. May leave a subdural CSF collection or may tear bridging veins. This complication occurs in as many as 10% of shunted patients, and is hard to treat - treatment requires balancing the therapeutic and adverse effects of the shunt by periodic clipping off.
• low pressure state - development of headache and vomiting on sitting or standing. Usually resolves with a high fluid intake and gradual mobilisation. If not, conversion to a high pressure valve may be indicated.
• less commonly, platelet fibrin emboli and thrombosis of internal jugular veins.
• shunt nephritis
• a rare complication is sclerosing peritonitis