Is CSF leak after shunt surgery normal?

Question

Hello doctor,

My sister-in-law had a shunt surgery in the brain for the hydrocephalus condition two weeks ago, and she was unconscious. However, they now suggest surgery for the CSF leak. We are very confused about what we should do. Is it possible to have a CSF leak after shunt surgery?

Kindly revert soon.

Answer 1

Hello,

Welcome to icliniq.com.

I feel sorry for all the pain your sister-in-law is going through. Hydrocephalus is a difficult problem to treat. The complications seen in your sister-in-law's case are very common in this type of patient.

I would suggest you to follow your doctors (neurosurgeon) advice, as the doctor seems to follow a standard protocol for the treatment of this commonly occurring problem with shunt surgery.

Remember, a few key steps in treatment are:-

CSF (cerebrospinal fluid) diversion flow to reduce intracranial tension (option is Chhabra shunt (cheap and good quality), pressure regulator shunt (costly)); complications with both are the same.

If the shunt system is exposed or there is a CSF leak, then we need to change the entire shunt system, as bacterial growth on the shunt can directly infect the brain and cause a life-threatening brain infection, further complicating the case.

Since these patients are emasculated (thin build and weak), we can use a head ring of cotton to support the head and avoid pressure on the shunt system and suture sites on the scalp.

Postoperative early mobilization in the form of frequent position changes in bed, making patients sit in chairs, etc., along with good nutrition (high protein diet).

Try to determine the cause of hydrocephalus and treat it as the patient's overall condition improves. Remember, the complication occurring in your sister's case is unfortunate, but it is very frequently seen. It is important that you act quickly to cover the first two steps of the treatment plan.

I hope she gets well soon.

Thank you.