Artikel
Is it possible to optimize treatment of patients with idiopathic normal pressure hydrocephalus by implanting an adjustable Medos Hakim Valve Codman® in combination with a Miethke Shunt Assistent Aesculap®?
Ist es möglich, die Therapie des idiopathischen Normaldruckhydrozephalus durch die Implantation eines programmierbaren Medos-Hakim-Ventils in Kombination mit einem Miethke Shunt-Assistenten zu optimieren?
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Veröffentlicht: | 8. Mai 2006 |
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Objective: A better course of the disease after implantation of a low-pressure valve in patients with idiopathic normal pressure normally comes at the great cost of a distinctly higher rate of overdrainage. Can combining an adjustable valve with a gravity unit produce an optimization of the treatment results?
Methods: In a prospective observation of the course of the disease, 25 patients with idiopathic normal pressure hydrocephalus were surgically treated with the aforementioned valve combination during the period from January to June 2004 and from July to December 2005 at the Unfallkrankenhaus Berlin and examined after 3, 6 and 12 months.
Results: The course of the disease correlates with the opening pressure level of the valve. The controlled setting of the valve from 100 mmH2O to 70 mmH2O as well as to 50 mmH2O after 3 months permits the brain to be adapted optimally to the implanted valve without complications from overdrainage.
Conclusions: In our view, combining an adjustable differential pressure valve with a gravity unit currently represents the optimal treatment variant for patients with idiopathic normal pressure hydrocephalus. In the future, the gravity valve should also be adjustable.