NPH and Shunt

Dear Ask The Doctor: Hi I am curious as to what is the generalized opinion of health care practitioners in the advent of doing a second shunt on an opposite site of an elderly, 88, woman, who has already had a shunt on the right side approximately 3 years ago for NPH, which helped, but now those pesky symptoms have come back. Thank you kindly. //Steve

Dear Steve: Normal pressure hydrocephalus (NPH) can be quite a debilitating disease. Symptoms may recur even after treatment with a shunt. The most common cause for recurrence of symptoms after successful shunt treatment is a malfunctioning shunt. This elderly lady should be investigated for this possibility. A second shunt should only be attempted if the present shunt malfunction cannot be corrected.