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

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?

Meeting Abstract

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  • corresponding author U. Meier - Department of Neurosurgery, Unfallkrankenhaus Berlin, Germany
  • J. Lemcke - Department of Neurosurgery, Unfallkrankenhaus Berlin, Germany

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 02.15

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

Published: May 8, 2006

© 2006 Meier 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: 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.