gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

The Miethke Dual Switch Valve – experience in 169 adult patients with different kinds of hydrocephalus

Das Miethke Dual Switch Ventil – Erfahrungen mit 169 erwachsenen Patienten mit unterschiedlichen Normen von Hydrozephalus

Meeting Abstract

  • corresponding author F. Hertel - Abteilung für Neurochrirugie, Brüderkrankenhaus Trier
  • M. Züchner - Abteilung für Neurochrirugie, Brüderkrankenhaus Trier
  • C. Decker - Abteilung für Neurochrirugie, Brüderkrankenhaus Trier
  • A. Lörcks - Abteilung für Neurochrirugie, Brüderkrankenhaus Trier
  • S. Schill - Euromedizinalkolleg, Brüderkrankenhaus Trier
  • I. Bosniak - Euromedizinalkolleg, Brüderkrankenhaus Trier
  • M. Bettag - Abteilung für Neurochrirugie, Brüderkrankenhaus Trier

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 02.14

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Hertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Despite the development of approximately 200 different shunt systems within the last 50 years, overdrainage and valve obstructions are still major problems in the current treatment of hydrocephalus. We report about our single institutions experience with the Dual Switch gravitational valve system (DSV) in patients with different kinds of hydrocephalus.

Methods: We retrospectively reviewed the clinical and radiological data of all patients who were treated with a DSV between 1998 and 2005 at our institution. A telephone interview was performed at the end of the study, to determine the overall shunt survival. We analyzed the outcome and the shunt - related complications

Results: Among 169 patients with a DSV, we had 70 patients with normal pressure hydrocephalus (NPH), 40 patients with communicating hydrocephalus due to SAH, 31 patients with communicating hydrocephalus not due to SAH and 28 patients with occlusive hydrocephalus. We had a rate of shunt responders of 93,2%, an overdrainage rate of 3,7% and no valve obstruction in the whole series. The overall shunt survival was 81% after 82 months (mean: 47,6 months).

Conclusions: In comparison to the lietature, the rate of system related complications overdrainage, valve obstruction) is low. In patients with NPH, were low opening pressures are essential, the DSV seems to bear an advantage because of a high drainage rate (low opening pressure in the supine position) and a, despite this, low rate of overdrainage. Even in patients with relatively high CSF protein content, we did not observe any valve obstruction. However, this study is a retrospective analysis and a prospective randomized controlled trial is requiered for the comparison of these valves with programmable and flow-controlled ones.