[Ventriculoperitoneal shunts with the use of pressure-adjustable valve in the management of hydrocephalus].
Sixteen patients with hydrocephalus of varied etiology who underwent ventriculo-peritoneal shunts utilizing pressure-adjustable valves were reviewed, and the usefulness of the pressure-adjustable valve in the management of hydrocephalus was evaluated. Before shunting all patients had CT evidence of hydrocephalus with Evans' Index greater than 30%. High-, medium- and low-pressure settings were chosen in 3, 11 and 2 patients respectively, according to the CSF pressure as measured during lumber puncture or ventricular drainage. Following the shunting procedures with programmable pressure valves, hydrocephalus was alleviated with Evans' Index being 27% on the average, as evaluated by CT scans. Such clinical symptoms as disturbed consciousness, dementia and increased intracranial pressure all subsided. There were no mortality, infection or revision during the follow-up period of 5 to 16 months. Of particular note was that, among these 16 cases, there were three illustrative cases in which programmable pressure valves were found useful in coping with newly developed subdural effusion and low-intracranial-pressure syndrome, by manually adjusting the valves to higher pressure settings.