Article
Gravitational shunt-units and bedridden patients – a problem?
Gravitationsunterstützte Shunt-Ventile und Bettlägerigkeit – ein Problem?
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Published: | April 11, 2007 |
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Outline
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Objective: Chronic hydrocephalus and shunt dependency is frequent in daily neurosurgery. Which valve serves best for which patient ist still under debate. We conducted this review in order to identify a subgroup of patients which is not optimally treated by modern shunt-valves with gravitational units.
Methods: We retrospectively reviewed our prospective hydrocephalus database and the corresponding patient charts from January 2006 up to now regarding the valve type used and their specific complications.
Results: During the last 11 months, 26 shunt systems were implanted in adults in our clinic. The ProGAV-valve (17 patients), the GAV-valve (8 patients) and the Hakim medos programmable valve (5 patients) were used. The etiology of hydrocephalus was as follows: NPH 10 patients, posthaemorrhagic 9 patients, tumor 6 patients, trauma 1 patient. 8 patients were preponderantly bedridden at the time of shunt insertion. 6 of these received valves with a gravitational units (2 ProGAV, 4 GAV). 4 of them presented with severe underdrainage resulting in a valve change in 2 patients. None of the bedridden patients with Hakim Medos programmable valves without gravitational unit developed an underdrainage during the length of their hospital stay.
Conclusions: Shunt systems with gravitational units are unsuitable for predominantly immobilized patients in the early postoperative state. There seems to be a problem with gravitational shunt-units and bedridden patients.