Experience with SM 8 300 Sophysa adjustable valve in adult chronic hydrocephalus

Mariann Kordás; Dusan Vitanovic; Sándor Czirják

Background: Adjustable valves provides a flexibility in the treatment of adult chronic hydrocephalus, but the valve opening pressure related problems, mostly the symptoms of overdrainage, remain the main causes of the major complications. On the base of our large experience with the programmable valves with opening pressure range 30 to 200 mm H2O, we had an impression that using the valve with higher opening pressure would decrease the complication rates, therefore we asked the company to provide us new valves with higher opening pressure. The aim of the study was to evaluate, weather using of the Sophysa SM 8 with opening pressure up to 300 mm H2O, would help to avoid the complications.

Methods and Results: Our single center prospective study started in 2002. One of the authors (MK) operated 126 adults with chronic hydrocephalus: 82 idiopathic NPH (INPH), 23 secunder NPH (SNPH) and 21 occlusiv type of chronic hydrocephalus - 9 out of 21 were after unsatisfactory result of IIIrd ventricle fenestration. During the operation the higher valve opening pressure was applied and in the course of the postoperative period adjustment was performed generally twice in every case. In both INPH and SNPH group 1 patient had shunt infection and after shunt removal new shunt was inserted. Only in the INPH group were 2 subdural haematoma required surgical intervention. 4 subdural hygroma could be managed with valve opening pressure adjustments.

Conclusions: Wider range of valve opening pressure improved the results of sugery.

1.Subdural fluid collection remained lower than before (126/6)

2.Because of very early postoperative mobilization the patients tolerated the intervention better.