[Gravity valves for idiopathic normal pressure hydrocephalus. A Prospective study of 60 patients].
OBJECTIVE
Are hydrostatic valves superior to conventional differential pressure shunts in patients with normal- pressure hydrocephalus, with regard to the postoperative results of treatment and possible complications?


METHODS
From September 1997 to January 2002, 60 patients with idiopathic normal-pressure hydrocephalus were treated by surgical implantation of a hydrostatic valve (Miethke dual-switch valve) at the Unfallkrankenhaus Berlin.


RESULTS
One year after the shunt operation, the clinical picture was very good for 33% of the patients, good for 33%, satisfactory for 17%, and poor for 17%. At 20%, the rate of postoperative complications (catheter dislocations, valve infections, underdrainage and overdrainage) is still relatively high. The opening pressure of the Miethke dual-switch valve did not correlate with the postoperative results of treatment.


CONCLUSIONS
According to our experience, hydrostatic Miethke dual-switch valves are superior to conventional differential pressure shunts without an additional gravity unit, especially with regard to the treatment of patients with idiopathic normal -pressure hydrocephalus, concerning both the postoperative results of the treatment and the incidence of possible complications. With differentiated diagnosis and therapy, a clinical improvement can be achieved for 83% of such patients.
Meier
U
U
Klinik für Neurochirurgie, Unfallkrankenhaus Berlin. ullrich.meier@ukb.de
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome