Signs and Symptoms of Complication

When things are going well, it’s easy to put the concerns about hydrocephalus and the complications that come with it out of your mind. However, it’s critical to understand the signs and symptoms of a shunt failure or the closure of an ETV. Seeing your physician or visiting the Emergency Department, even if symptoms are not ultimately related to hydrocephalus, the shunt, ETV or ETV/CPC, is the right choice. Seeking immediate medical attention can identify a resolvable complication and enable you or your family member to avoid brain damage or even death, especially in children.

Symptoms of shunt malfunction or ETV closure vary considerably from person to person, but recurring failures tend to have similar symptoms for a particular person. When an abrupt malfunction occurs, symptoms can develop very rapidly potentially leading to coma and possibly death. In infants and toddlers, it’s important to be aware that medication with a side effect of drowsiness can mimic or mask signs of shunt malfunction or ETV closure and should be used with caution in those with hydrocephalus, especially infants and young children.

Infants

  • Enlargement of baby’s head
  • Fontanel full and tense when infant is upright and quiet
  • Prominent scalp veins
  • Swelling along shunt tract
  • Vomiting
  • Sleepiness
  • Irritability
  • Downward deviation of eyes
  • Less interest in feeding
  • Fever, potentially present with shunt failure or infection
  • Redness along shunt tract, potentially present with shunt failure or infection

Toddlers

  • Enlargement of head
  • Swelling along shunt tract
  • Vomiting
  • Headache
  • Sleepiness
  • Irritability
  • Loss of previous abilities (sensory or motor function)
  • Fever, potentially present with shunt failure or infection
  • Redness along shunt tract, potentially present with shunt failure or infection

Children and Adults

  • Vomiting
  • Headache
  • Vision problems
  • Irritability and/or tiredness
  • Swelling along shunt tract
  • Personality change
  • Loss of coordination of balance
  • Difficulty waking up or staying awake (this symptom requires urgent attention as it can potentially lead to a coma)
  • Decline in academic or job performance
  • Fever, potentially present with shunt failure or infection
  • Redness along shunt tract, potentially present with shunt failure or infection

Older Adults with Normal Pressure Hydrocephalus

People who are diagnosed and treated in adulthood, including those with NPH, tend to revert to the symptoms they experienced before initial treatment when they are experiencing a shunt malfunction.

  • Difficulty walking/Gait disturbances
  • Cognitive challenges/Mild dementia
  • Urinary Urgency or incontinence
  • Fever (sign of shunt failure or infection)
  • Redness along the shunt tract (sign of shunt failure or infection)
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