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Riding with a VP shunt - advice?

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Hi guys.

A couple of years ago I inexplicably developed Hydrocephalus - restriction between 3rd and 4th ventricles. I ended up getting a VP (Ventricular Peritoneal) shunt put in the right ventricle with the drain going down my neck from the base of the skull, down my sternum, and into the peritoneal cavity. They stuffed up first time by putting in a fixed valve which over-drained the CSF, collapsing my left and right ventricles completely resulting in massive subdural hematoma's. That was rectified by putting in a variable valve with an anti-siphoning valve and I've pretty much made a full recovery. But my brain has clearly been through a lot.

Just last year I got back into riding after a dozen years off the bike. Everyone says I am a fool, but they don't realise how much enjoyment I get out of it. I got myself a good helmet (O'neal Series 8), Leatt neck brace, and all the other safety gear - but I'm most concerned about my head and neck obviously. Despite my best efforts, I have had a few stacks where I ended up bumping my helmet - but more glancing hits on the ground rather than full on headbutting the ground. That was until my last fall...

With the last fall I had a high speed over the handlebars get-off. Fortunately my left shoulder took the brunt of the fall (breaking my collarbone clean in half in the process), but it's the first time head took a decent knock too. In the emergency room they did the neuro tests and I was fine, but obviously shaken. The doctor and nurse tending to me were not shy to tell me how much of an idiot I was. Same goes for my mother and girlfriend. And to cap it off my ortho weighed in with a similar opinion when he checked my collarbone out.

So, anyone with decent medical knowledge - am I really being that much of an idiot? Am I really gambling with my life by doing any form of dirtbiking? Is there anything in particular I could do to protect myself any more (e.g. specific helmet type/brand, neck brace, etc? At a minimum I'll get a medic-alert bracelet stating I have a VP shunt together with its setting so that if the worst should happen the medics know what to focus on. After I have an accident, is there anything in particular I should be watching for? Should I demand to have a CT/MRI scan or trust the neuro tests are sufficient?

Thanks in advance for your help.

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I'v got a VP shunt installed when I was a baby (35 years ago!) has been completely problem free for the last 22 years. Including when I've hit my head doing things like wiping out snow skiing on a less-than-fluffy slope and getting wrestled to the ground on a hardwood floor. Granted, those aren't motorcycle crashes, but they are data points worth considering in the risk assessment.

The best I can come up with (other than my own experience mentioned above) is this:

http://www.medscape.com/viewarticle/553964_3

Which basically says there's a lot of disagreement among doctors over what kids with shunts should be allowed to do, and very very few reports of any real consequences of doing the things in question (organized school sports).

So I'm going for it. I'm getting my first bike, a Honda CBR250r, and I recognize that I'm taking a risk that there's no real data to quantify. The bike should be arriving at the dealer this week and I'm excited!

The only completely safe thing to do in this world is stay in bed.

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I dont know anything about a VP Shunt, but broken bones I do, well Ill tell you other than a few select medical types all of them have told me I am nuts, my surgeon, my general practitioner, my wife (also an RN), they all think I am stupid except one who is an avid downhill MTB rider...he gets it.

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The shunt itself does not put you at increased risk over the population at large for traumatic brain injury. Of course, your brain has suffered some insult so it may be easier to injure with trauma because of that but not because of the VP shunt. I say take all appropriate precautions and keep on rocking in the free world.

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a literature search reveals that there has been only 2 reported shunt failures from "trauma." 1) failure attributable to the G forces of a roller coaster 2) a blow to the head behind the ear with the shunt resulted in failure of the shunt valve.

There are probably other cases that have not been reported. I suspect the incidence is exceeding rare.

My advise...spend your money on great suspension! CAM, MD

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a literature search reveals that there has been only 2 reported shunt failures from "trauma."...

My advise...spend your money on great suspension! CAM, MD

Thanks mate. I have just gotten home from a emergency replacement of the valve as it failed (almost unheard of, but just my luck). Chatted to 3 different neurosurgeons about it and all 3 had the same opinion as your research indicates - just ride and enjoy it. :thumbsup::busted:

Really relieved to hear that I must say :smashpc:

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