Children with spina bifida often have other medical conditions secondary to their neural tube defect, which may or may not present themselves in any one individual. They include hydrocephalus, Chiari II Malformation, tethered spinal cord, bladder and bowel complications, and orthopedic problems including spinal curvatures, hip dislocation, or club feet. Children with spina bifida and hydrocephalus may also face learning challenges and are prone to obesity. Individuals with shunted hydrocephalus and their caregivers need to learn the signs and symptoms of shunt malfunction. Although a shunt is designed to stay in place for life, it may malfunction due to a blockage, kinking or problem with the valve. If this happens, the shunt will need to be surgically revised or replaced.

Symptoms of Shunt Malfunction*:

Infants:

• fontanelle is full and bulging when baby is upright and quiet

• marked scalp veins

• swelling or redness along the shunt tract

• fever

• vomiting

• unusual irritability

• unusual tiredness

• downward deviation of the eyes (sunset sign)

• seizures (abnormal twitching)

• gradual head enlargement

Toddlers:

• fever

• vomiting

• unusual irritability

• swelling or redness along the shunt tract

• loss of previous abilities

• seizures (abnormal twitching)

• headache

• unusual tiredness

• gradual head enlargement

Children/Adults:

• headache

• nausea or vomiting

• unusual tiredness

• unusual irritability

• arching of head backwards

• fever

• difficulty with vision

• personality change

• loss of coordination or balance

• swelling or redness along the shunt tract (infrequent)

• difficulty in walking

• seizures (abnormal twitching)

• decline in school or work activities

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*from Understanding Spina Bifida, Bloorview MacMillan Centre 1998