Your child had a cut (skin incision) and a small hole drilled through the skull. A small cut was also made in the skin and muscles of the belly. A valve was placed underneath the skin behind the ear or at the back of the head. A tube (catheter) was placed into the brain to bring the fluid to the valve. Another tube was connected to the valve and threaded underneath the skin down into your child's belly or elsewhere, like around the lung or in the heart.

Any stitches or staples that you can see will be taken out in about 7 to 14 days.

All parts of the shunt are underneath the skin. During the first few days after the surgery, the area at the top of the shunt may be raised underneath the skin. As the swelling goes away and your child's hair grows back, there will be a small, raised area about the size of a quarter that is usually not noticeable.

Do not shower or shampoo your child's head until the stitches and staples have been taken out. Give your child a sponge bath instead. The wound should not soak in water until the skin is completely healed.

Do not push on the part of the shunt that you can feel or see underneath your child's skin behind the ear.

Your child should be able to eat normal foods after going home unless your surgeon tells you otherwise.

Your child should be able to do most activities:

• If you have a baby, handle your baby the way you would normally. It is OK to bounce your baby.
• Older children can do most regular activities. Talk with your surgeon about contact sports.
• Most of the time, your child may sleep in any position. Check this with your surgeon as each child is different.

Your child may have some pain. Children under 4 years old may take acetaminophen (Tylenol). Children age 4 and older may be prescribed stronger pain medicines if needed. Follow your surgeon's instructions or instructions on the medicine container, about how much medicine to give your child.

The major problems to watch for are an infected shunt and a blocked shunt.

Contact your child's surgeon if your child has:

• Confusion or seems less aware
• Fever of 101°F (38.3°C) or higher
• Pain in the belly that does not go away
• Stiff neck or headache
• No appetite or is not eating well
• Veins on the head or scalp that look larger than they used to
• Problems in school
• Poor development or has lost a developmental skill previously attained
• Become more cranky or irritable
• Redness, swelling, bleeding, or increased discharge from the incision
• Vomiting that does not go away
• Sleep problems or is more sleepy than usual
• High-pitched cry
• Been looking more pale
• A head that is growing larger (this is only seen in children 18 months or younger)
• Bulging or tenderness in the soft spot at the top of the head
• Swelling around the valve or around the tube going from the valve to their belly
• A seizure

Shunt - ventriculoperitoneal - discharge; VP shunt - discharge; Shunt revision - discharge; Hydrocephalus shunt placement - discharge

Badhiwala JH, Kulkarni AV. Ventricular shunting procedures. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 227.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 88.

Tan TQ, Mithal LB. Infections related to prosthetic or artificial devices. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 74.

Updated by: Luc Jasmin, MD, Ph.D., FRCS (C), FACS, Department of Neuroscience, Guam Regional Medical City, Guam; Department of Surgery, Johnson City Medical Center, TN; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.