[The treatment of hydrocephalus in infants and children using hydrostatic valves]

Complications of CSF-shunt systems may not only prolong hospitalization, but also influence dramatically the neurological and mental outcome of patients, especially of premature newborns. Shunt complications may be caused by mechanical problems such as shunt occlusion or dysfunction of the valve itself. Another cause of shunt complications is the overdrainage and, lastly, shunt infection. The choice of the specific shunt system seems to play an important role in avoiding the above mentioned complications. In this study 32 children with hydrocephali due to different etiologies were treated with hydrostatic valves, the so called Pädi GAV (pediatric hydrostatic valve) valves developed by Miethke. In addition to mechanical occlusions and shunt infections, the overdrainage related complications, such as subdural hematomas/ fluid collections, slit ventricles and secondary craniosynostoses were taken into consideration. None of the patients showed these complications. On the contrary, postoperative MRI or the ultrasound demonstrated prominent ventricles comparing these with those of non-hydrocephalic children as measured by the Evans-Index and FOR (fronto-to-occipital ratio). Whether the overdrainage-related complications actually reduced using Pädi GAV valves will be shown by further long-term follow ups. This study aims to evaluate the initial experience with the Pädi GAV shunt system, particularly with respect to the overdrainage-related problems.