First and foremost, let me say that I am a Grey’s Anatomy fan– not for the medical accuracy for sure– but it is a guilty pleasure of mine. So, considering the known medical inaccuracies I’ve seen, I don’t have to be a neurosurgeon to guess that they are likely a little loose with the surgical details.
Neurosurgeons place VP (ventriculostomy-peritoneal) shunts. What is that?
A VP shunt is a tube that is placed in a person’s brain, specifically the ventricle, to drain off excess cerebrospinal fluid (CSF). Placing a VP shunt is primary treatment for a condition called hydrocephalus where there is excess accumulation of CSF in the brain. Too much CSF will lead to increased intracranail pressure– which can be deadly.
A VP shunt helps keep the brain at an even pressure by draining extra fluid into the perotoneal cavity (or your gut.)
Here is a primer on traumatic brain injury. This post covers some important principles of managing traumatic brain injury. For quick review, the skull contains three components: your brain, blood, and CSF.
Back to Grey’s.
Derek (aka McDreamy) and his surgeon wife adopt a baby named Zoila. One of the principle reasons for the adoption was that the child (approx 2 y/o) had a VP shunt and Dr. McDreamy would be an expert at managing her condition.
So, when the child begins to have vomiting and fever– he makes the statement, “Well, she just has the flu.”
The first thought in a neurosurgeon’s mind, until ruled otherwise, is that something is wrong with the shunt in her head!
This concept is drilled into emergency medical personnel– particularly pediatrics, that if a person with a VP shunt presents with headache, vomiting, and fever– it is an emergency. First assumption is something is wrong with the shunt and if not treated, the person could have elevated intracranial pressure (which is bad) and die (which is super bad!)
Classic symptoms for increased pressure in the brain is headache and vomiting. These could mean that the shunt is obstructed and no longer draining CSF. Fever could indicate the shunt is infected– which essentially means the patient has a brain infection (meningitis)– another really bad thing.
So for super surgeon, McDreamy, to blow this off as a viral illness is a big no-no. Off to the ER little Zoila should have gone.