[Shunting operation with the medos programmable valve shunt system].
We reviewed 13 patients with hydrocephalus of varied etiology and two patients with arachnoid cyst who underwent shunting operations using Medos programmable valve shunt system. This shunt system allows 18 pressure settings, ranging from 30 to 200mmH2O in 10mmH2O differentials, percutaneously. Following the shunting operation, the size of the ventricle or arachnoid cyst was reduced in all cases and the clinical symptoms improved in 14 cases. The valve pressure was reset during the postoperative course in all cases. In five cases, resetting was performed because of management of complications. In the others, it was performed to find the most appropriate valve pressure for each patient. Complications were subdural effusion (2 cases), chronic subdural hematoma (2 cases) and slit ventricle syndrome (1 case). Subdural effusion and slit ventricle syndrome were improved easily by resetting the valve pressure, but both cases of chronic subdural hematoma finally required surgical treatment. Artifacts in MR imaging and movement of the valve pressure by MR imaging were small and created no clinical problem. In cases 1 and 2, clinical symptoms and CT finding were improved by a change of 30mmH2O. In case 2, hydrocephalus with slight subdural effusion followed a good course with frequent change of the valve pressure. Accordingly, we consider the Medos system to be useful for a more thorough treatment of hydrocephalus and arachnoid cyst after shunting operations.
Izumihara
A
A
Department of Neurosurgery, Shuto General Hospital.
Orita
T
T
Tsurutani
T
T
Kajiwara
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D016080:Arachnoid Cysts / Q000601:surgery*; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006408:Hematoma, Subdural / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007223:Infant; D008297:Male; D008875:Middle Aged; D011312:Pressure; D013353:Subdural Effusion / Q000209:etiology