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Joined: Jan 21, 2008 Posts: 119 Location: Bs As. Argentina
Posted: Thu Mar 06, 2008 6:23 am Post subject:
Welcome back mate.....happy to hear everything went well. Gotta say that i never seen anyone with such spirit. Must be very hard for you and your family. But you keep it up......i reckon it'll help a lot.
Posted: Thu Mar 06, 2008 12:30 pm Post subject: thank you
thank you guys for the support all of you have been more supportive that even my long term friends im still recovering feeling tired so i hope this will be it for awhile god and others still want me here thank you and all my tegu family
jeff _________________ TEGUS TEGUS AND MORE TEGUS
Posted: Thu Mar 06, 2008 6:34 pm Post subject: some more info on Vp shunts and function
Ventriculoperitoneal Shunts
The function of cerebrospinal fluid is not entirely understood.
However, cerebrospinal fluid is believed to be an ultrafiltrate of
blood that cushions the brain. It allows for removal of metabolic
products and the proper environment for neuro- transmission.
Most CSF is produced by the choroid plexus in the lateral, third and
4th ventricles. It moves from the point of production secondary to
differences in pressure, by cilia action, blood vessel pulsation, and
respiratory variations. After production, it passes from the lateral
ventricle through the paired foramina of Monro into the third
ventricle. CSF is resorbed in the superior sagital sinus by arachnoid
villous activity in a process of active transport that is affected by
CSF pressure.
Hydrocephalus
Overproduction of CSF- unusual and caused only by choroid plexus
papilloma
Blockage of the normal flow of CSF.
Communicating or Absorptive- blockage of the resorption of CSF in the
arachnoid villi, basal cisterns, or subarachnoid space. The
ventricles are patent and all 4 are enlarged.
Non-communicating- Obstruction proximal to the foramina of Lushka and
Magendie at the outlet of the 4th ventricle.
Tumors
Cysts
Infection and hemorrhage
Congenital malformations
Aqueductal stenosis
The best treatment for hydrocephalus is the placement of a
extracranial shunt from the ventricles to an outside absorptive
surface (i.e., ventriculoperitoneal, ventriculo-atrial,
ventriculopleural, etc.)
Shunts
Shunts usually consist of three parts
Proximal end that is radiopaque and is placed into the ventricle.
This end has multiple small perforations.
Valve- this allows for unidirectional flow. Can adjust various
opening pressures. Usually has a reservoir that allows for checking
shunt pressure and sampling CSF
Distal end that is placed into the peritoneum or another absorptive
surface by tracking the tubing subcutaneously
Shunt malfunctions
Median survival of a shunt (before need for revision) in a child
under 2 years of age is 2 years; over two years of age is 8 - 10
years.
Signs and symptoms include headache, malaise, general not feeling
well, vomiting, mental status alterations, increased blood pressure,
head circumference increase, Cushings triad, bulging fontanel, sixth
nerve palsy signs, Macewen's sign, changes in gait, and personality
changes. There may also be an increase of seizures and a complaint of
neck pain. The parents often know that something is wrong. Teachers
may state that there has been a change of school performance
Obstruction- most often the proximal tip is obstructed with cells,
choroid plexus, or debris. May also have kinking of the tubing and
migration of the distal end.
Diagnosis by suspicion based on signs and symptoms and confirmed by
CT scan of the head or shunt tap or lumbar puncture for CSF pressure
elevation (ALWAYS RECORD A PRESSURE WHEN DOING AN LP!!!!).
Infection-
signs include fever, meningeal signs, vomiting, signs and symptoms of
shunt malfunction, abdominal pain, and peritonitis.
There may be evidence of purulent material around the shunt insertion
site and redness along the shunt tract
Most common organisms are S. epidermidis and S. aureus. Also gram
negative organisms.
Diagnosis by positive blood cultures, shunt fluid cultures, or lumbar
puncture cultures. Also the presence of greater than 10 cells in the
fluid is suggestive of infection.
Infection peaks in the first few weeks after a shunt insertion.
Infection years after shunt placement is rare unless the skin is
broken over the tubing.
Treatment
Antibiotics including Vancomycin and Gentamycin
External Ventricular Drainage
Removal of the shunt.
Disconnections and breakage of tubing are another cause of
malfunction, though less common than occlusion.
Migration into the scrotum, perforation of the bowel wall, and
intussuseption are all rare complications in the peritoneum
In a child with a ventriculoperitoneal shunt, the shunt is
statistically unlikely to be the cause of any specific problem.
However, if family members suspect shunt malfunction or no other
cause for fever, malaise, behavioral change, etc., can be found
(i.e., ear infection), careful and diligent evaluation of the shunt
is mandatory.
References
The Shunt Book. Drake and St. Rose, 1996.
Iskander BJ et al. Pitfalls in the Diagnosis of Ventricular Shunt
Dysfunction: Radiology Reports and Ventricular Size. Pediatrics.
1998; 101(6):1031-1036.
Madikians A and Conway EE. Cerebrospinal Fluid Shunt Problems in
Pediatric Patients. Pediatric Annals. October 1997. _________________ TEGUS TEGUS AND MORE TEGUS
Joined: Oct 16, 2007 Posts: 2556 Location: San Antonio,TX
Posted: Thu Mar 06, 2008 10:16 pm Post subject:
Wow.I'm speechless.I'm sorry to hear that your long term friends haven't been more supportive.At least you have your loving family.That is the most important part and God of corse .We are glad to hear that we ( the Tegu forum family ) can make you feel welcomed and cared for here.
Posted: Fri Mar 07, 2008 1:18 pm Post subject: thank you
thank you again sam you are the best im still not 100 percent yet having vision problems which are signs that ill be having another surgery praying hoping that ill have a break
jeff _________________ TEGUS TEGUS AND MORE TEGUS
Joined: Nov 01, 2007 Posts: 224 Location: Harrison, ME
Posted: Mon Mar 10, 2008 8:36 am Post subject:
Wow - that is some serious information. So what is your prognosis? Do you simply learn to live with the shunt and it keeps all your pressures normal? Is this something that gets cured or treated?
Can't believe they had you in and out in essentially 24 hours. You must have an HMO. Just kidding! _________________ Renee
Posted: Mon Mar 10, 2008 10:18 am Post subject: surgery
tegster when i have a revision they only keep me 1 day and then out. i have doctors appt. for the next 2 weeks and then going to new york for probally another surgery vp stunts are know to fail already had one place and 2 days later failed so all together i had 20 surgeries in 2 years thank you im still recovering
jeff _________________ TEGUS TEGUS AND MORE TEGUS
Joined: Jan 29, 2008 Posts: 150 Location: Mar del Plata, Argentina
Posted: Mon Mar 10, 2008 11:51 pm Post subject:
Man, I'm a cold blood man when talking about blood and wounds but that scar looks scary! Thanks God you are ok, party on! _________________ Did you say "tame"? Let me show you what that means: http://www.youtube.com/watch?v=2RvhG2j6zOs
Joined: Oct 16, 2007 Posts: 2556 Location: San Antonio,TX
Posted: Tue Mar 11, 2008 1:39 pm Post subject:
wow.I don't know what to say and that doesn't happen very often.I can't imagine what you have to go threw.I wouldn't be able to keep those staples in there.They would bug the heck out of me.But I thank God for the technology that we have now days that help some one like you to get surgery and get better.Hopefully you don't have to have to many more.Don't for get we will keep you in our prayers.Keep hanging in there like you have been.Say hi to your family from us.Take care and good luck.
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Wow.I'm speechless.I'm sorry to hear that your long term friends haven't been more supportive.At least you have your loving family.That is the most important part and God of corse 
.We are glad to hear that we ( the Tegu forum family ) can make you feel welcomed and cared for here.
thank you.Please try to give your eyes some rest.
On 3-6-08 had a surgery will be posting pics have a bigger scar now 
