The Use of the Programmable Valve Shunt System in the Management of Patients with Hydrocephalus

ABSTRACT

OBJECTIVE: The goal of this study was to clarify the value of the programmable valve shunt system to readjust the pressure noninvasively for the adequate cerebrospinal fluid(CSF) drainage. METHODS: The authors analyzed a single-center retrospective study of 54 patients suffering from hydrocephalus of various causes, as aneurysm(21 patients), trauma(13 patients), normal-pressure hydrocephalus(NPH, 7 patients) and so on. In 51 cases a programmable valve was implanted at the first shunt implantation. In three cases the shunt was replaced to a programmable valve system. RESULTS: In 33 patients(61%) of cases valve pressure adjustment was required at least once(total number of readjustment 54, mean 1.7, maximum 5) for the reason of underdrainage(36) or overdrainge(18). The range of reprogrammed valve pressure was 10 to 90mmH2O(mean 11.1+/-15.9mmH2O), the radiological finding improved 48.6% of frontal horn index at the beginning of reprogramming to 41.3%, and the clinical symptom related with hydrocephalus improved in 29 patients(87.8%) of pressure adjustment. Shunt reprogramming was necessary in patients with congenital hydrocephalus(100%), aneurysm(55%), NPH(71%), trauma(50%); the programmable valve proved particularly beneficial for overdrainge as subdural hygroma. CONCLUSION: The programmable valve was useful for the correction of overdrainge or underdrainage by the easy control of valve pressure without any invasive procedure.