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Question:

My late partner had pnuemoccal meningitis when he was 50 developing hydrocephalus as a complication of his condition. He had a shunt inserted to control the hydrocephalus. The advice given on leaving the hospital was that adults rarely have problems with shunts. My partner had an appointment with consultant once subsequently but felt he didn't have a chance to ask the questions he wanted to ask. My partner died 10 years later (3 years ago)from cerebral odema caused by shunt malfunction. He had experinced ongoing problems with balance / vertigo a few years before he died - a GP referred him for heart tests which showed nothing wrong. A year & a half before he died his personality began to change. He was very agitated. A year before he died he stopped wotk. He spent most of each day in bed. I assumed he was profoundly depressed although he denied this. 20 months before he died he was admitted to hospital after fainting several times & kept in one night. 10 months before he died he had meningitis type symptoms - vomited & lost consciousness - when the ambulance crew arrived began having fits. When a lumbar puncture & CT scan showed no infection he was discharged & referred to a community psychiatrist. My question is whether there should or could be regular follow up appointments for adults with shunts for hydrocephalus as a complication of meningitis? This would at least raise levels of awareness that a problem linked either to meningitis or the shunt might occur.

Answer:

Dr Simon Nadel says:

I am sure that anyone with a shunt needs regular follow up, either with a neurosurgeon or a neurologist. However, I am not up to date with adult practice, so an adult neurologist/neurosurgeon would be worth talking to.

The symptoms of shunt malfunction can be very non-specific, and all the symptoms described could suggest a problem with the shunt, although there may be many different causes.

I think any odd symptoms in someone with a shunt could suggest shunt malfunction and a neurology/neurosurgery opinion should be sought.

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