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Management of hydrocephalus
Shunt alert cards A small information card stating the type of shunt a person has and the symptoms of malfunction. Mainly for use in emergency situations. Available through Shine and your local Support and Development Worker (see overleaf for more information). GP leaflet A guide to hydrocephalus will be sent to your GP on request. Remember, you may be the only patient he/she has with hydrocephalus, so he/she will need all the information available. Referral procedure If you have not been seen by a neurosurgeon in the last 5 years to have your shunt checked, you will need to be re-referred to the hydrocephalus clinic via your GP. Baseline scans Even though you are not experiencing any problems with your shunt, it is advisable that a baseline scan is taken when you are well. This will help to determine treatment, should you develop any pressure problems, the consultant will then know the size of your ventricles when well. If you have not had a scan in the last 5 years, you may need a referral - see referral procedures above. Eye check Individuals with a shunt are advised to have eye checks every 6 months. Raised intracranial pressure may cause pressure at the back of the eyes. Eye checks therefore assist early diagnosis.

Management of hydrocephalus
Hydrocephalus

Managed by a shunt?

3rd Ventriculostomy?

Not managed / arrested?

Shunt checked in the last 5 years by a neurosurgeon? YES NO

Are you monitored by a neurosurgeon? NO YES

Have you seen a neurosurgeon in the last 5 years NO YES

Do you carry a shunt card? YES NO

Ask your GP to refer you to a neurosurgeon?

A baseline scan maybe due, please overleaf for details

Please see overleaf and continue NO

Please see overleaf and continue

Do you have an eye check every 6-12 months?

Are you aware of these symptoms listed?

Infants
Enlargement of head Full, tense fontanelle Swelling, redness on shunt tract Fever Irritability Seizures Sunset eyes

Toddlers
Enlargement of head Fever Vomiting Headache Irritability Sleepiness Swelling, redness on shunt tract Seizures

Children & Adults

Headache Vomiting Fever, swelling, redness on shunt tract Irritability Ataxia Personality changes Visual disturbances Decline in academic performance Confusion Seizures Sleepiness Incontinence

Have you a combination of any of these symptoms at the moment? YES

INTERMITTENTLY

YES
ALL THE TIME

NO

Options: 1. Contact GP (24 hours) 2. Contact consultant via secretary advice (9-5) 3. Contact childrens ward (24 hours), adults go to A&E. 4. Contact Shine on: 01733 555988.

Need to attend specialist neurosurgical centre within 4 hours of symptoms appearing.

If you are already referred to a neurosurgeon, you will usually receive appointments for check-ups every year or so.

SHUNT ALERT CARDS

Shine has a series of Shunt Alert Cards, for adults and children. These should be carried at all times by people with hydrocephalus treated by a shunt (this will include some people with spina bifida). The cards are available from Shine, Telephone 01733 555988. The card emphasises that, if the cardholder is showing signs similar to those which occur when there is shunt blockage or infection, urgent assessment of shunt function should be carried out in a specialist neuro-surgical unit in order to eliminate shunt failure as a cause. People applying for a Shunt Alert Card can also request

that an information sheet about hydrocephalus, specially written for doctors, is sent to their GP. Teachers and employers can ask for Shunt malfunctions: a guide to symptoms and suggested actions for schools/employers.

Help us
Shine relies on peoples generosity and support so we can help our clients who depend on us for help and advice - people with hydrocephalus, spina bifida, their families and carers. To donate to Shine please visit www.shinecharity.org.uk or call 01733 555988. This information has been produced by Shines medical advisers and approved by Shines Medical Advisory Committee of senior medical professionals. Shine - Registered charity no.249338 To see our full range of information sheets and to find out how to donate to Shine please visit www.shinecharity.org.uk