De-mystifying the Shunt

Although hydrocephalus and shunts are a great deal more common than encephaloceles, it's still not exactly common knowledge what they are and what the surgery is designed to do.  I learned a little about them in my rehabilitation counseling training, and there was actually a woman in my masters program who had both hydrocephalus and a shunt - pretty inspiring!  So my really simple explanation is this:  hydrocephalus is basically the buildup of cerebral spinal fluid in the brain.  We all make lots and lots of CSF every day and it is just naturally absorbed.  The neurosurgery resident yesterday compared CSF to Gatorade.   I'm not sure I completely understand that analogy, but I guess his point was that it's good for the body.  Children with hydrocephalus don't have the ability to reabsorb the fluid, or the flow of the fluid in the central nervous system gets blocked - causing it to collect in the ventricles of the brain.  This is why the heads of children with hydrocephalus can become very large.  The fluid compresses and crowds the brain tissue and doesn't allow it to grow normally. 
A shunt is a long, thin tube with a valve.  The neurosurgeon will make two incisions - one small one in her stomach and a slightly larger curved one in her scalp.  He'll then make a small hole in Gianna's skull, and insert the tube to drain the CSF.  The tube will go underneath the skin down the back of her head and all the way to her stomach.  A large amount of the thin tube will be inserted into her stomach (3-4 feet of tube!) so that it will grow with her as she grows.  It's hard to believe there's enough room in that little stomach for that much tubing!  Once the shunt is inserted, she will need to have it for life.  The valve is in the brain to regulate how much fluid drains to the stomach, where it will be absorbed.  Once the fluid gets to a certain pressure level, then the valve will open and some of the fluid will drain.  Here's a couple of pictures that give an idea of how this works.

Of course there are you-tube videos that show the entire surgery to insert a VP shunt into an infant, for those of you with a stronger stomach than mine.  I think for now I prefer these cartoon illustrations!