Nurses know best!!!

P_RN, ADN, RN · Aug 22, 2001

I had this from the Florida Neurosurgery site

http://www.a1webs.com/virtualtrials/doug/shunts.cfm

More information would be needed. Is this for a class or a personal experience? Was the baby seen by a pediatric neurosurgeon? Were any meds aside from Diamox tried? Any steroids?

P

prmenrs, RN · Aug 22, 2001

My son has posthemorrhagic hydrocephalus; he is 17 now. He did well w/a V-P shunt until the amount of CSF exceeded his abdomen's capacity to absorb, also d/t extensive scarring. They tried breaking up the adhesions--they just reformed. So they put the distal end into his gall bladder! I'd never heard of that before. They could also have put it into his plueral space, if they had not been able to get to the gall bladder (b/o of the scarring). Don't know if this is an option b/o his size--they'd have to re-place it every time he grew some more.

This baby's in a tough spot--good luck!

Slowone · Aug 26, 2001

Thank you both for your responses they were VERY helpful. The pt is my son, he was born w/ CDH & PPH and was on ECMO for 24 days. He was intubated for 3.5 months. He had his hernia repaired at 2 weeks old (while on ECMO) and returned from surgery with an abd silo (required gastroschehsis). He has had a pyloreplasty, gtube placement and Nissen-fundoplication. He dev. a SVC clot from the ECMO that did not respond to TPA. His head circumf. started heading off the charts about 3 months ago and he was subsequently dx'd w/communicating hydrocephalus. He has had mult CT's and one MRI. He is obviously a poor candidate for a V-P or V-A shunt and the Diamox caused him to pant (which isn't the best for a kid w/ chronic lung disease)

I have been told that shunting is the next step and I will approach them tommorow about considering the gallbladder, the neurologist I spoke to yesterday hadn't heard of that "but it sounds reasonable" he said. We see the Neurosurgeon Monday to discuss a game plan, but thank you for the help, the article was very informative as well!

My nursing skills are limited to those who can at least tie there own shoes, so this has been quite a learning experience for me.

Thanks:D