ANGOL NYELVŰ PUBLIKÁCIÓK KIVONATAI:
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
2.Because of very early postoperative mobilization the
patients tolerated the intervention better.