Management of hydrocephalus with programmable valves
AIM: To evaluate the effectiveness of programmable valves with hydrocephalus patients and to ascertain complications and safety issues arising from their use. METHODS: Programmable valves were used in 36 patients with hydrocephalus from 2004 to 2007. The frequency readjustments and complications of post-operation were analyzed. Outcomes of patients were collceted by follew up, and the results were compared in patients with hydrocephalus using standard valves. RESULTS: Significant sustained clinical improvement was achieved in 32/36 ( 89% ) of patients with programmable valves. The overall infection rate was 4/36 (11%) , valve blockage occurred in 2 cases and no subdural effusion or subdural hematoma demonstrated and no patient was reoperate owning to CSF overshunting or undershunting. The total readjustments were 46. In contrast, 6 paitents with standard valves developed intracranial hemorrage or subdural effusion. There was no difference in infection and valve obstruction between programmable and standard valves. CONCLUSION: Programmable valves can be safely used for treatment of hydrocephalus, and consistent with the cerebrospinal fluid circulation, reduce the either over-or under-drainage of the complications. The possibility of modifying their working pressure seems to constitute their main advantage. Catheter-related complications and shunt-related infections were the main reasons for revision and the major cause of shunt failure.
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