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Related Experiment Videos

Experience with a programmable valve shunt system.

N Yamashita1, K Kamiya, K Yamada

  • 1Department of Neurosurgery, Nagoya City University, Nagoya, Japan.

Journal of Neurosurgery
|July 2, 1999
PubMed
Summary

The Codman Hakim programmable valve effectively treats hydrocephalus, but requires frequent reprogramming and careful patient selection. Magnetic field sensitivity necessitates post-MRI pressure checks.

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Area of Science:

  • Neurosurgery
  • Biomedical Engineering

Background:

  • Hydrocephalus and other intracranial fluid-accumulating diseases require effective cerebrospinal fluid (CSF) management.
  • Programmable valves offer adjustable CSF flow rates, but their clinical efficacy requires thorough evaluation.

Purpose of the Study:

  • To assess the efficacy and complications of the Codman Hakim programmable valve in managing hydrocephalus and related conditions.
  • To identify patient populations and clinical scenarios where the programmable valve is most beneficial.

Main Methods:

  • Analysis of clinical data from 179 patients with hydrocephalus or similar conditions treated with the Codman Hakim programmable valve.
  • Evaluation of shunt reprogramming frequency, reasons for reprogramming, and patient outcomes post-intervention.

Main Results:

  • Shunt placement was effective in 168 patients (93.8%), with 50.6% requiring postoperative reprogramming of opening pressure.
  • Reprogramming improved symptoms related to inadequate or excessive CSF drainage, particularly in posthemorrhagic acute hydrocephalus.
  • Complications occurred in 7% of patients, with valve obstruction being the most common, especially in those with brain tumors.

Conclusions:

  • The programmable valve is beneficial for hydrocephalus treatment but requires careful patient selection, particularly avoiding brain tumor cases due to higher complication risk.
  • The valve's sensitivity to magnetic fields necessitates checking opening pressure after magnetic resonance imaging (MRI).
  • Development of a patient identification system is recommended to inform medical personnel about the valve and its settings.

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