Abstract
Auto-reprogramming of Programmable Differential Pressure Valves with and without an Active Locking Mechanism NPH Patients
Neurosurgery, v 67(Supplement_1)
01 Dec 2020
Abstract
INTRODUCTION Normal pressure hydrocephalus (NPH) is best treated with cerebrospinal fluid diversion in appropriately selected patients. There are various options for shunt valve systems that can be used, which include fixed or programmable differential pressure valves with or without an active locking mechanism (ALM). Shunt valves with an ALM require the application of manual pressure to the valve in order for a magnet to engage it for adjustment. There have been studies showing that magnetic fields of electronic devices such as mobile phones and tablets as well as MRI can lead to auto-reprogramming of valves without an active locking mechanism versus those with one. METHODS In our retrospectively collected series of forty-eight NPH patients who underwent ventriculo-peritoneal shunt placement from 2016-present at one institution by a single neurosurgeon, we examined the rate of auto-reprogramming and its adverse effects when comparing these two valve systems. RESULTS Of 48 patients that received a shunt, 19 patients had shunt valves without an ALM while 29 had valves with an ALM. Each shunt valve system also included an overdrainage regulation device. Auto-reprogramming was seen in 4/19 (21%) patients without an ALM. There was no observed auto-reprogramming in any of the ALM valves. 3 of the auto-reprogramming events led to the formation of both symptomatic chronic subdural hematomas (2) and subdural hygromas (1). Both of the chronic subdural hematomas required burr hole evacuation as well as valve replacement with valves manufactured by other companies. The patient with the symptomatic subdural hygroma required shunt valve adjustment. CONCLUSION From our experience, shunt valves that have an ALM are safer than those without due to the lack of auto-reprogramming and its associated adverse sequelae. This is extremely important in NPH patients given their age, brain atrophy, and tendency to be on anticoagulation - all risks for development of SDH.
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Details
- Title
- Auto-reprogramming of Programmable Differential Pressure Valves with and without an Active Locking Mechanism NPH Patients
- Creators
- Brandon Kujawski - Oxford University PressAlfredo Munoz - Oxford University PressMohamed Elnokaly - Oxford University PressJody Leonardo - Oxford University Press
- Publication Details
- Neurosurgery, v 67(Supplement_1)
- Publisher
- Wolters Kluwer Health, Inc
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Surgery
- Other Identifier
- 991022059917404721