gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Preliminary experiences in the treatment of chronic hydrocephalus using the Miethke GA Valve

Vorläufige Ergebnisse in der Behandlung des chronischen Hydrozephalus mit Miethke GA Ventil

Meeting Abstract

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  • corresponding author Anna Maria Dorothea München - Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar
  • R. Eymann - Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar
  • W. I. Steudel - Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar
  • M. Kiefer - Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg/Saar

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.02.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0029.shtml

Veröffentlicht: 23. April 2004

© 2004 München et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Since last year a new G-valve, the Miethke GAV, is available. Its most important features are a low opening pressure (OP) in prone position and its small dimensions. We present our preliminary data.

Methods

26 patients suffering from a hydrodynamic proven chronic hydrocephalus of various ethiologies received a Miethke GAV. In all but one patients a ventriculoperitoneal drainage was preferred. To document the clinical course we used our own classification (Homburger Hydrocephalus Scale [HHS]). To measure the ventricular size we used the EVANS and FOHR index. The follow-up lasts between 2 - 14 months (average: 5 ± 3 months). Each patient was re-evaluated 2 and 12 months after operation. Statistics: Student's T-test; Spearman-rank-correlation (α = 5%).

Results

20 patients received a GAV with an OP = 5cm H2O in prone position. The patients experienced a significant clinical improvement, while the ventricular size reduction was only marginal. A correlation between clinical improvement and ventricular shrinking could not be verified. 65% of the patients experienced a good or excellent recovery, while 23% had to be termed as non-responders. Despite the usage of a low OP for prone position no overdrainage occurred even in cases of LOVA hydrocephalus, which bears a significant risk for this because of the large discrepancy between scull and brain volume. The most important complication was an allergy like irritation of the peritoneum in nearly 50% of the patients, which disappeared within 3 months without further treatment.

Conclusions

The results of the GAV are similar to those known from other G-valves. Most important: even with the usage of a relatively low OP for prone position we had no significance of an increased risk of overdrainage. This may be attributed to our policy to counteract the hydrostatic pressure a bit more aggressively than usual. The large number of peritoneal irritation cannot be explained.