Ventricular shunt (hydrocephalus)

The brain is bathed in a fluid, cerebrospinal fluid, which circulates through cavities called ventricles. When this fluid builds up because it does not circulate or drain properly, the ventricles enlarge and pressure rises inside the skull: this is hydrocephalus. It can occur at any age: in children, after a haemorrhage, an infection or a tumour, or in older people in a form called normal pressure hydrocephalus. Symptoms vary: headache, vomiting and drowsiness when pressure rises quickly; walking difficulties, memory problems and urinary leakage in the form seen in older people. A shunt involves placing a thin flexible tube in a ventricle, connected to a valve under the skin, which carries the excess fluid to the abdomen (ventriculoperitoneal shunt), where it is naturally absorbed. The whole system lies under the skin and is not visible from the outside. In some forms, an endoscopic third ventriculostomy, which creates a new drainage route inside the brain, avoids the need for a valve. In an emergency, a temporary external drain may be placed. At Clinique Pasteur Tunis, imaging is carried out in the radiology department, the operation is performed by a neurosurgeon, and post-operative monitoring can take place in intensive care when needed.