Objectives: Hydrocephalus can be defined as clinically symptomatic dilatation of the internal ventricular system at the expense of brain and blood volume. Shunt insertion is the mainstay of therapy for communicating hydrocephalus. One of the most frequently used valves is the programmable Codman Medos Hakim valve which enables the pressure level to be adjusted from 30 to 200 mmH2O. The problem of functional over- or underdrainage and the associated complications should be significantly reduced if not excluded. Especially in the clinical application of the Codman Medos Hakim Shunt System in hydrocephalus of other etiology only a few studies can be found. This study aims to increase knowledge of both the safety of Codman Medos valves with SiphonGuard in the clinical application as well as the correct choice of the pressure level for different indications.
Patients And Methods: In this retrospective study, 101 patients were included who underwent surgery with the adjustable "Codman Medos Hakim" valve with "SiphonGuard" between January 2010 and July 2013. We analyzed the patient files and imaging (CCT, cMRT) data. The statistical examinations were performed using the WINStat program for Excel.
Results: Our results show that an initial pressure level of 120mmH2O proved to be suitable in all subgroups. After optimization of the initial pressure level 70.3% of the valves (71 valves) had a pressure level of 120mmH2O. Importantly, only in the SAH subgroup the clinical improvement was correlated with a reduction in the measured indices. But in all subgroups a clinical deterioration was associated with an increased ventricular size.
Conclusion: Overall, the clinical data show that an initial pressure level of 120mmH2O seems to be appropriate for most patients treated in this series. Measured indices from the cranial imaging can provide valuable indications for the presence of a suboptimal valve setting for the individual patient.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.clineuro.2018.08.023 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Measurement and Assessment of Head-to-Helmet Contact Forces.
Ann Biomed Eng
January 2025
Department of Mechanical and Industrial Engineering, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA.
Purpose: To evaluate the population variation in head-to-helmet contact forces in helmet users.
Methods: Four different size Kevlar composite helmets were instrumented with contact pressure sensors and chinstrap tension meters. A total number of 89 volunteers (25 female and 64 male volunteers) participated in the study.
Purpose: To evaluate the effect of osilodrostat and hypercortisolism control on blood pressure (BP) and glycemic control in patients with Cushing's disease.
Methods: Pooled analysis of two Phase III osilodrostat studies (LINC 3 and LINC 4), both comprising a 48-week core phase and an optional open-label extension. Changes from baseline in systolic and diastolic BP (SBP and DBP), fasting plasma glucose (FPG), and glycated hemoglobin (HbA) were evaluated during osilodrostat treatment in patients with/without hypertension or diabetes at baseline.
Blood-brain barrier integrity disruption is associated with both chronic vascular risk factors and white matter hyperintensities.
J Prev Alzheimers Dis
February 2025
Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine - Nanyang Technological University, Singapore. Electronic address:
Background: Cardiovascular risk factors (CRFs) like hypertension, high cholesterol, and diabetes mellitus are increasingly linked to cognitive decline and dementia, especially in cerebral small vessel disease (cSVD). White matter hyperintensities (WMH) are closely associated with cognitive impairment, but the mechanisms behind their development remain unclear. Blood-brain barrier (BBB) dysfunction may be a key factor, particularly in cSVD.
View Article and Find Full Text PDFIntegrated metabolomics and mass spectrometry imaging analysis reveal the efficacy and mechanism of Huangkui capsule on type 2 diabetic nephropathy.
Phytomedicine
January 2025
State key laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine, National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China; Department of Nephrology, Nephrology Institute of the Chinese People's Liberation Army, National Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China. Electronic address:
Background: Huangkui capsule (HKC), a Chinese patent medicine, is clinically used for treating diabetic nephropathy. However, the core disease-specific biomarkers and targets of type 2 diabetic nephropathy (T2DN) and the therapeutic mechanism of HKC are not fully elucidated.
Purpose: This study aimed to investigate the therapeutic effects and underlying molecular mechanisms of HKC for T2DN.
An inventory analysis of waste tyre generation and management in South Africa.
Waste Manag
January 2025
Green Engineering Research Group, Department of Chemical Engineering, Faculty of Engineering and The Built Environment, Durban University of Technology, Durban 4001, South Africa.
Global waste generation, particularly waste tyres, is a significant issue, with South Africa contributing significantly to this problem. In 2021, 1.5 billion waste tyres were generated, with an expected 4.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!