Interest of the adjustable opening pressure valve in the treatment of hydrocephalus and arachnoid cysts. Analysis of a series of 50 cases

Objective: The objective of this work is to evaluate the results of a draining valve of the cerebrospinal fluid, whose opening pressure is transcutaneously adjustable, in the treatment of intracranial collections. Material and methods A series of 50 operated patients is retrospectively reviewed. Forty-four patients are treated for hydrocephalus of variable causes and six patients for arachnoidal cysts. Offering eight opening pressures, the adjustable valve Sophy was used in all these patients. The mean follow-up is of 48 months. Results: Nineteen patients [38%] needed an adjustment of their valve's opening pressure. This adjustment was achieved to higher levels in seven patients presenting with overdrainage and to lower levels in twelve patients presenting with underdrainage. In 4 patients a subdural collection was observed and treated. Six patients underwent a second surgery for infection or obstruction. Taking all etiologies into consideration, and after the adjustment of the valve's opening pressure, 40 patients had a positive clinical result [obvious amelioration of the symptomatology], ten patients did not improve. Conclusion: The valve Sophy provides a simple solution for the patients in whom it is difficult to choose an adapted opening pressure, it particularly allows to avoid a reintervention when this is rendered necessary by a hypo or a hyper drainage programmable valve

Approche stereotaxique des lesions cerebrales profondes

The authors report a retrospective study [April 92-April 95] of 60 CT guided stereotactic biopsies. The procedure offered accurate histological diagnosis in 56 cases. There were 38 glial tumors, the majority being of high grade [III-IV]. Five abscesses were evacuated and medically treated. Complications occurred in 5% of cases. These results are compatible with those reported in the literature. The simplicity and accuracy of stereotactic procedure are confirmed, making it an imperative step in the management of intra-axial space occupying lesion when surgical resection is negotiable. The other applications of the stereotactic procedure are exposed