If you or your child is scheduled for shunt surgery, knowing what to expect can ease a lot of anxiety. While every case is different and your surgical team will give you specific instructions, this article offers a general picture of the journey before, during, and after the operation.
Before surgery In preparation, you can expect:
- Evaluation and imaging — confirming the diagnosis and planning the procedure with CT or MRI.
- Pre-operative instructions — typically including not eating or drinking for a set period before surgery, and guidance on medications.
- Discussion and consent — the surgeon explains the procedure, benefits, and risks, and answers your questions. This is a good time to ask anything on your mind.
- Preparation of the surgical site — part of the hair may be shaved or trimmed where incisions will be made.
During surgery Shunt placement is performed under general anesthesia (you're asleep). In general terms:
- The surgeon makes a small incision in the scalp and a small opening in the skull to place the ventricular catheter into a ventricle.
- A second, small incision is made at the drainage site (usually the abdomen).
- The tubing is tunneled under the skin connecting the two, with the valve positioned (often behind the ear).
- The system is checked, and the incisions are closed.
The operation typically takes around an hour or so, though this varies. It's a commonly performed, well-established neurosurgical procedure.
After surgery — in the hospital. Following the operation:
- You'll recover and be monitored, initially in a recovery area, then on a ward.
- There may be some headache, discomfort, or nausea at first, managed with medication.
- The team monitors for symptom improvement and watches for any early problems.
- Imaging may be done to check ventricle size and catheter position.
- The hospital stay is often a few days, depending on the situation and recovery.
After surgery — recovery at home. Once home:
- Follow instructions on incision care, activity, and bathing.
- Expect a gradual return to normal activities over days to weeks, per your team's guidance.
- Some swelling or a visible/palpable tract along the tubing under the skin is normal early on.
- Attend follow-up appointments, which are important for confirming the shunt is working well.
What to watch for afterward Know the warning signs that need prompt medical attention, including:
- Signs of infection — fever, redness, swelling, or tenderness along the incisions or shunt tract, or feeling unwell (most concerning in the early weeks).
- Signs of shunt malfunction or pressure problems — worsening headache, vomiting, drowsiness, vision changes, or return of original symptoms.
- In babies — a bulging fontanelle, irritability, poor feeding, or sleepiness.
These warning signs (covered in detail in the complications articles) are important to recognize, because early treatment of any problem leads to the best outcomes.
A reassuring note Shunt surgery is one of the most common neurosurgical procedures, and for most people it brings significant relief of symptoms and a return to normal life. Feeling nervous is completely natural — don't hesitate to ask your surgical team to walk you through anything you're unsure about. Knowing the plan, and knowing the warning signs to watch for afterward, helps you approach the surgery and recovery with greater confidence.