Is it possible to optimize treatment of patients with idiopathic normal pressure hydrocephalus by implanting an adjustable Medos Hakim valve in combination with a Miethke shunt assistant?

Full Abstract

A better course of the disease after implantation of a low-pressure valve in patients with idiopathic normal pressure hydrocephalus normally comes at the cost of a distinctly higher rate of overdrainage. Can combining an adjustable valve with a gravity unit produce optimization of treatment results? In a prospective observation of the course of the disease, 18 patients with idiopathic normal pressure hydrocephalus were surgically treated with the aforementioned valve combination during the period January to June 2004 at the Unfallkrankenhaus Berlin and examined after 6 and 12 months. The course of the disease correlates with the opening pressure level of the valve. The controlled setting of the valve from 100 mmH2O to 70 mmH2O, then to 50 mmH2O after 3 months permits the brain to adapt optimally to the implanted valve without complications from overdrainage. In our view, combining an adjustable differential pressure valve with a gravity unit currently represents the optimal treatment variant for patients with idiopathic normal pressure hydrocephalus. In the future, the gravity valve should also be adjustable.

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Author information

Author/s: Meier, U (U); Lemcke, J (J);

Affiliation: Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany. ullrich.meier(-atsign-)ukb.de

Journal and publication information

Publication Type: Journal Article

Journal: Acta neurochirurgica. Supplement (Acta Neurochir Suppl), published in Austria. (Language: eng)

Reference: 2006-; vol 96 (issue ) : pp 381-5

Dates: Created 2006/05/04; Completed 2006/06/12;

PMID: 16671490, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Aged, 80 and over
Cerebrospinal Fluid Shunts - instrumentation; statistics & numerical data
Equipment Failure Analysis
Female
Germany - epidemiology
Humans
Hydrocephalus, Normal Pressure - diagnosis; epidemiology; surgery
Incidence

Incidence
Longitudinal Studies
Male
Middle Aged
Prognosis
Prosthesis Implantation - methods; statistics & numerical data
Quality Assurance, Health Care - methods
Risk Assessment - methods
Risk Factors
Treatment Outcome

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