[The effectiveness of gravitational valves in the prevention of over-drainage in adult patients with hydrocephalus].
OBJECTIVE
To evaluate the effect of gravitational valves on over-drainage in hydrocephalus in adults.


METHODS
We performed a retrospective study of the shunt systems placed in patients over the age of 18 years between 1998 and 2006. Patients were divided into two groups: non-GV group (without gravitational valve) and GV group (with a gravitational valve, Aesculap-Miethke 5/35). The complications that occurred during the first year following the placement of the shunt system were recorded.


RESULTS
Of a total of 137 patients, 91 were from the non-GV group and 46 belonged to the GV group. Mean age: non-GV group, 62.1 years; and GV group, 64.2 years, without any significant differences. In 80 patients the aetiology was chronic adult hydrocephalus, 19 were due to expansive processes, 15 due to vascular causes, eight pseudo tumours, six post-traumatic injuries and nine were due to other causes. In the non-GV group, 9.89% presented over-drainage, whereas there were no cases in the GV group; the difference was statistically significant (p = 0.029). In the rest of the complications there were no significant differences between the two groups. The total complications in the non-GV group were 25.27% and in the GV group, 6.52%, and there were significant differences (p = 0.01), although, above all, at the expense of over-drainage, because if this complication was excluded, then the differences were no longer significant (p = 0.175).


CONCLUSIONS
In our series, the use of gravitational valves in the prevention of over-drainage in adult hydrocephalus proved to be more effective than employing valves without the gravitational device.
de Quintana-Schmidt
C
C
Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. cquintana@santpau.es
Rodríguez-Rodríguez
R
R
Molet-Teixidó
J
J
Clavel-Laria
P
P
Català-Antúnez
I
I
Puerta-Roldán
P
P
Montes-Graciano
G
G
Tresserres-Ribó
P
P
Muñoz-Hernández
F
F
Bartumeus-Jené
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006112:Gravitation; D006801:Humans; D006849:Hydrocephalus / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies