gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

Technical malfunction of programmable valves

Meeting Abstract

  • Dieter Class - Otto-von-Guericke-Universität, Universitätsklinik für Neurochirurgie, Magdeburg, Deutschland
  • Dimitrios Karagiannis - Otto-von-Guericke-Universität, Universitätsklinik für Neurochirurgie, Magdeburg, Deutschland
  • Jana Kohl - Otto-von-Guericke-Universität, Universitätsklinik für Neurochirurgie, Magdeburg, Deutschland
  • Raimund Firsching - Otto-von-Guericke-Universität, Universitätsklinik für Neurochirurgie, Magdeburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.08.05

doi: 10.3205/17dgnc415, urn:nbn:de:0183-17dgnc4153

Published: June 9, 2017

© 2017 Class et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: The use of programmable valve systems offers the possibility to adjust pressure settings according to need especially in a growing child. Increasingly sophisticated technology includes various therapeutical options but the possibility of shunt malfunction or technical failure of the implanted valve itself is reality,too. We report on 9 patients with an isolated technical failure of a CODMAN HAKIM and a SOPHYSA POLARIS programmable valve.

Methods: We reviewed the clinical course and radiological findings of 9 patients (6 children and 3 adults) treated at our department between 2007 and 2016. CODMAN HAKIM and SOPHYSA POLARIS programmable valves were used. Results of the examination of the explanted valves by the manufactoring companies are included. Special attention was paid to the mechanisms which could be considered a likely cause of valve failure like trauma, inflammation, repeated adjustment procedures and MRI examinations with different technology and magnetic field strength applied.

Results: 3 adults and 5 children had a CODMAN HAKIM programmable valve: in 7 patients revision was necessary due to stator dislodgement and 1 girl had a similarly defective valve but the shunt system at present seemed to be no longer needed so it was left in place. Time span between implantation and revision of the valve was between 5 and up to 15 years. 1 child had a SOPHYSA POLARIS valve which could not be adjusted as the boy suffered from overdrainage syndroms so revision was necessary 3 years after primary implantation. Head trauma involving the valve system with close connection to the time of damage of the valve was not associated with failure of the valve. Exposure to magnetic fields with the exception of MRI scannings was not reported. No isolated causative mechanism for valve failure was detected.

Conclusion: Stator dislodgement in a programmable valve and the failure to adjust valve pressure settings in a symptomatic patient are very rare conditions but when occuring possibly connected to serious complications. Mostly surgical revision with implantation of a new valve was necessary to secure shunt function. No single causative mechanism could be detected in our patient group. Advantages and risks of different valve systems available should be reflected in an international database to come to further conclusions and to establish recommendations for daily treatment worldwide .