L Ventriculoperitoneal shunt
A ventriculoperitoneal shunt is placed to relieve increased CSF pressure. The hydrocephalus may be caused by a congenital defect, cyst, tumor, trauma, infection, or CBF absorption abnormality. Therefore, patients undergoing this procedure range in age from newborn to elderly. Besides a conduit to the peritoneum, the ventricle can also be drained into the pleura or right atrium.
2. Preoperative assessment
b) Headaches are the most common symptom. Assess for level of consciousness, headaches, nuchal rigidity, seizures, nausea or vomiting, and papilledema as indications of severe hydrocephalus (ICP >15 mmHg). Presurgical neurologic defects such as stroke, spina bifida, and focal defects should also be assessed.
c) Review results of CT of the head. Review blood pressure and heart rate trends in relation to ICP. Cushing triad is present with increased ICP and includes increased blood pressure, and decreased heart rate, and irregular respirations.
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