Effectiveness of the Medos Hakim Programmable Valve in the Treatment of Various Type of Hydrocephalus

ABSTRACT

OBJECTIVE: To evaluate the advantages of Medos Hakim programmable valve system in the treatment of various type of hydrocephalus. MATERIALS AND METHODS: We retrospectively analyzed 33 patients who underwent ventriculoperitoneal shunt with Medos Hakim programmable valve system from December 1995 to June 1998. They were followed from 1 month to 35 months(mean 10.6 months). RESULTS: The overall outcome were excellent in 8 patients, improvement but residual symptoms in 16 patients and unchanged in 9 patients. There were 8 complications; overdrainage with subdural fluid collections(4 cases), infections(2 cases), obstruction(1 case) and mechanical failure(1 case). Overdrainage with subdural fluid collections was managed by readjustment of valve operating pressure alone in 3 cases and by observation in 1 case. Readjustment of valve pressure was needed more in children than in adults. There was significant correlation between opening and final pressure and the opening pressure was important for choosing the initial valve operating pressure at the time of implantation. CONCLUSION: In this study, we found that the Medos Hakim programmable valve is beneficial in cases with slowly progressive hydrocephalus and very large ventricles, especially in children, in order to normalize the ventricle size slowly with avoiding subdural hygromas.