shunt malfunction - know the signs and symptoms in children

Shunt Malfunction – Know the Signs and Symptoms in Children (Free Printable Included!)

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I know as a mom of a son who was born with hydrocephalus how worrisome it can be thinking about leaving your child in the care of someone else who does not know what signs to look for if a shunt was to start malfunctioning in your absence.

The only thing I received was a small booklet about hydrocephalus. Within its pages was a one page list explaining what symptoms to be aware of for shunt malfunction laid out in a list format. The booklet talked about how sometimes a shunt malfunction can be very sudden and symptoms can occur quickly, sometimes in a matter of hours or days.

The booklet also explained how important it was for early treatment to avoid serious complications. As if I wasn’t worried enough already, reading this really caused me great concern. My thought was everyone who looks after my child needs this information!

So, I searched in the best place for a free printable on signs of shunt failure… Pinterest. And you know what? I did not find one printable! Then I searched Google for a printable. Nothing. I could not believe that no one had created a printable on the signs of shunt malfunction when this was such a serious topic.

That’s why today I have a gift for you! It’s a free printable listing the signs of shunt malfunction in infants, toddlers, and children. There are four pages; one for each appropriate age (infants, toddlers, and children) and one page that combines all of them together.

How Long Does a Shunt Last?

Here are some statistics on shunt malfunction:

  • The average lifespan of a shunt for infants is 2 years (okay, that’s a scary thought!)
  • The average lifespan of a shunt for children over the age of two is 8-10 years
  • The average number of revisions is 1-2 every 10 years
  • Up to 4 in 10 shunts malfunction in the first year after surgery (another disturbing fact!)

With those odds it seemed like a good idea to let all caregivers know what signs and symptoms to look for in shunt malfunction. That way I could have peace of mind when I had to leave my son with the grandparents, the babysitter, at daycare, in the church nursery, at preschool, or anywhere else that I was not.

shunt failure - know the signs of shunt malfunction in children with hydrocephalus - free printable

What Complications Come from Having a Shunt?

I have researched that there are five common types of complications that arise from having a shunt.

  • Obstruction – This is a partial or complete blockage in the shunt which causes shunt malfunction. The CSF fluid starts backing up in the brain causing signs of hydrocephalus. The blockage could be due to blood cells or bacteria.
  • Infection –  Shunt infection is typically right after shunt surgery and is caused by contamination of the shunt. But infection can still be likely to occur even up to six months after the placement of a shunt. Treatment for these types of infections should be done immediately to avoid life-threatening illnesses or brain damage.
  • Overdrainage – This occurs when the shunt allows the CSF to drain too quickly from the ventricles in the brain which could cause the ventricles to collapse, broken blood vessels, and hemorrhages. Symptoms of overdrainage are headaches.
  • Underdrainage – This happens when the shunt is not draining CSF quickly enough and the fluid begins to build up in the ventricles and the symptoms of hydrocephalus recur.
  • Other Complications – Although shunts are very durable, they do tend to break down eventually. Catheters can become calcified or broken off. Components of the shunt can become disengaged or fractured due to the child’s growth or the age of the shunt.

Overdrainage and underdrainage are typically addressed by adjusting the rate of the flow of the shunt valve. If your child has a programmable VP shunt, the neurosurgeon can adjust the pressure setting in his office with a magnetic programmable device.

What are the Signs of Shunt Malfunction?

For infants

The signs of shunt malfunction are:

  • Enlargement of the baby’s head
  • The soft spot (fontanel) is full and tense when the infant is upright and quiet
  • Prominent scalp veins
  • Swelling along the shunt tract
  • Vomiting
  • Irritability
  • Sleepiness and/or hard to wake
  • Downward deviation of the eyes
  • Less interest in feeding
  • Fever
  • Redness along the shunt tract
  • Seizures

For Toddlers

The signs of shunt malfunction are:

  • Head enlargement
  • Vomiting
  • Headache
  • Irritability
  • Personality change
  • Sleepiness and/or hard to wake
  • Loss of previous abilities (sensory or motor functions)
  • Loss of appetite
  • Fever
  • Redness or swelling along the shunt tract
  • Loss of coordination or balance
  • Seizures

For Children

The signs of shunt malfunction are:

  • Vision problems
  • Vomiting
  • Headache
  • Irritability and/or tiredness
  • Personality change
  • Loss of appetite
  • Loss of coordination or balance
  • Difficulty waking up or staying awake
  • Decline in academic performance
  • Fever
  • Redness or swelling along the shunt tract
  • Seizures

How Often Should a Shunt Be Checked?

Since every child’s situation is different, there is no hard and fast rule on this one. My son has a ventriculoperitoneal (VP) shunt. He was seen by his neurosurgeon every six months for the first two years and then moved to once a year after the age of two. He has had no complications with his shunt and no seizures so I assume that could be the reason why they scheduled it like that.

This question is one to discuss with your child’s neurosurgeon since he knows your child’s history.

What Precautions Should My Child Take with a Programmable VP Shunt?

Magnets and EMFs

It is a known fact that magnets can change the pressure valve setting on some VP shunts depending on the type of shunt it is. The effects could either be reversible or irreversible.

One study by NCIB proved that certain smart phones did have an effect on the programmable valves of two types of shunts. The effect was reversible on one type and irreversible on the second type.

It’s important to know the model of the programmable VP shunt your child has, and to read all guidelines before using a product with a magnet.

Here are a few guidelines for shunts:

  • Use cell phones on the opposite side of the head from the shunt
  • Be wary of your child using audio headsets until you have checked the manufacturer’s guidelines
  • Be aware of strong magnets and keep them away from your child, especially in close proximity of the shunt
  • Be alert for signs that the programmable valve has changes. Signs to watch for would be the same as those listed above.


Each time your child has an MRI, the technician needs to know your child has a programmable shunt. After the MRI your child will need to be seen by the neurosurgeon to have the shunt checked and reprogrammed. This needs to be done within four hours after the MRI.

If there is no one available to reprogram the shunt, do not have the MRI done.

MedicAlert Jewelry

It a good idea for your child to wear a MedicAlert bracelet stating that he has hydrocephalus and the model of his programmable VP shunt.

These bracelets are affordable and a great way to let others know about your child’s condition in the event that you are not there to speak on his behalf.

For more information and to order online, visit MedicAlert’s site here.

Abdominal Surgery

If your child needs abdominal surgery, the surgeon needs to know your child has a VP shunt so that precautions can be taken with the tubing.

Physical Activities

It is not recommended to play in contact sports, martial arts, or ride rollercoasters that accelerate at a rapid pace. All of these activities should be done with extreme caution.

Do you know what signs to look for in shunt failure? Does your child's caregiver? Discover what those signs are and get a free printable to hand out to anyone who looks after your child.

What Concerns Do You Have as a Parent?

Let me know what your concerns are about shunts and shunt malfunctions. And don’t forget to get your free printable so other caregivers know what signs to look for in the event that the shunt starts to malfunction.


Smartphones and Programmable Shunts

Programmable VP Shunts

Hydrocephalus and Shunts from BMJ Journals

4 in 10 Shunts Malfunction in the First Year

Lifespan for VP Shunt in Infants

VP Shunts

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  1. Hi,

    Thank you for this.
    I am 27 and was born with Hydrocephalus. I Struggle alot with headaches, but I don’t know if my shunt is malfunctioning….how do I know it is not working? Because the headaches are driving me nuts….sometimes I just want to sleep my headache off….but I can’t always sleep, because I have to work….I am afraid to go and find help, because I don’t want peope to see me as weak. But I feel that the older I get, the worse the headaches get. And I am tired. Kind regards Louise

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