title: Clinical experience with a pressure-adjustable valve SOPHY in the management of hydrocephalus.
abstract: Seventy-four patients with hydrocephalus due to a variety of causes were treated with a cerebrospinal fluid (CSF) shunt, incorporating a recently developed pressure-adjustable valve SOPHY (PAVS). The PAVS may be changed percutaneously with the help of an externally applied magnet in order to select a high-, medium- or low-valve opening pressure, whenever the need for a change in pressure characteristics seems necessary to the neurosurgeon. The percutaneous pressure adjustment obviated up- or downgrading of a medium pressure position by surgical means in half of our patients during the follow-up time (up to 39 months; mean follow-up 16.7 months). In 66 patients (89%) decreased ventricle volume and improvement of the clinical sign of increased intracranial pressure were established. In 11 patients a valve or a catheter infection occurred; in 6 of these patients the valve had to be removed. Half of this group consisted of patients under 2 years of age. Significant technical complications related to the PAVS did not occur in our series but until a somewhat smaller PAVS is available, we cannot recommend its use in neonates or in small infants. In all other patients the PAVS is a very valuable instrument in the surgical management of hydrocephalus because it makes shunt revisions for inadequate valve pressure obsolete in individual patients.
authors.affiliation: Neurochirurgische Universitätsklinik, Düsseldorf, Federal Republic of Germany.
authors.forename: C B
authors.initials: CB
authors.lastname: Lumenta
authors.forename: N
authors.initials: N
authors.lastname: Roosen
authors.forename: U
authors.initials: U
authors.lastname: Dietrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013677:Medical Laboratory Science; D008875:Middle Aged