====== Delayed shunt insufficiency ======

Delayed [[shunt insufficiency]] refers to a situation where a previously functioning [[cerebrospinal fluid shunt]] [[system]], used to treat conditions like hydrocephalus, begins to fail or underperform after a period of normal function. This delay can happen weeks, months, or even years after the initial shunt placement. 

===== Causes =====

Mechanical [[Shunt Obstruction]]: Blockage in the shunt system, often due to debris, tissue, or blood clots.

[[Shunt Infection]]: Infection of the shunt or its components, leading to inflammation and blockage.

[[Cerebrospinal fluid shunt malfunction]]: The valve in the shunt might stop working correctly, leading to insufficient drainage.

[[Shunt Migration]] or [[Shunt Disconnection]]

The shunt tubing might shift or disconnect, disrupting the flow of CSF.
   
===== Symptoms =====

   - Similar to the symptoms of the original hydrocephalus, including headaches, nausea, vomiting, vision problems, changes in mental status, and in severe cases, lethargy or coma.
   - New or worsening neurological deficits, such as difficulty walking, memory problems, or seizures.
   
===== Diagnosis =====

[[Delayed shunt insufficiency diagnosis]]



===== Treatment =====

   - **Surgical Revision**: Often required to correct the insufficiency, which might involve replacing or repairing the shunt.
   - **Antibiotics**: If an infection is present, antibiotics are essential, sometimes combined with shunt removal and external ventricular drainage.
   
5. **Prognosis**:
   - The outcome varies depending on the cause and the timeliness of intervention. Prompt treatment can lead to recovery, while delays may result in permanent neurological damage or worsening of the underlying condition.

Managing delayed shunt insufficiency requires careful monitoring and often prompt surgical intervention to prevent serious complications.