Gravitational Shunts in Longstanding Overt Ventriculomegaly in Adults

Kiefer, M.; Eymann, Regina; Strowitzkí, Martin; Steudel, Wolf-Ingo

doi:10.1227/01.neu.0000134596.66114.e7

Cited by 33 publications

(21 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The explanation touted for this is that only a small volume of CSF needs to be drained to achieve near-physiological ICP in adult hydrocephalus [11]. Improvements in radiological CSF flow and ICP after ETV for LOVA have been identified [1, 13].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of long-standing overt ventriculomegaly in adults (LOVA)

2016

View full text Add to dashboard Cite

BackgroundLongstanding overt ventriculomegaly in adults (LOVA) is characterised by chronic hydrocephalus presumed to begin during infancy, but arresting before becoming clinically detectable. Later in life clinical features of hydrocephalus ensue, typically in the 5th or 6th decades. Only a relatively small number of LOVA case series have been published, and ambiguity remains regarding optimal management. This case series describes a series of patients with LOVA treated successfully at a single neurosurgical institution using endoscopic third ventriculostomy (ETV).MethodsA series of 14 patients were diagnosed with LOVA using established clinical and radiological criteria. All patients underwent an ETV and their clinical conditions were followed up for up to 5 years post-operatively.ResultsFourteen patients (100 %) reported either improvement or halt of progression in their presenting symptoms 3 months after ETV; 93 % of patients (n = 13) did not require any further surgical intervention. One patient (7 %) reported deterioration in symptoms beyond 3 months post-operatively, which necessitated further surgery (ventriculoperitoneal shunt). These promising outcomes after ETV are mirrored in numerous other LOVA case series. Other works have analysed the value of CSF shunting procedures in LOVA, with mixed results. A direct, prospective comparison of outcomes after shunt procedures and ETV, with a specific focus on LOVA patients, is yet to be completed. A minority of patients fail to respond, or develop recurrence of symptoms, months or years after initial surgical intervention.ConclusionsETV is an attractive option for surgical treatment of LOVA. After surgical treatment for LOVA, long-term follow-up should be considered to screen for late recurrence of the condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical treatment of long-standing overt ventriculomegaly in adults (LOVA)

2016

View full text Add to dashboard Cite

show abstract

“…Gravitational devices with fixed opening pressures have proved their role in the prevention of CSF overdrainage in ventriculoperitoneal (vp) shunts [4][5][6][7]. However, the selection of the optimal opening pressure of the gravitational device for the individual patient remains difficult and patient-valve mismatch does occur [12].…”

Section: Introductionmentioning

confidence: 99%

PROSAIKA: A prospective multicenter registry with the first programmable gravitational device for hydrocephalus shunting

Kehler

Kiefer

Eymann

et al. 2015

Clinical Neurology and Neurosurgery

Self Cite

View full text Add to dashboard Cite

“…11 Differential-pressure valves with adjustable opening pressures and gravitational valves with fixed opening pressures had been developed to overcome complications related to overdrainage. 6,7,15 These developments reduced the sequelae of overdrainage substantially. The subdural hematoma rate dropped from 15.4% with a fixed DP valve to 9.7% with an adjustable DP valve, and to 1.6% with a gravitational valve.…”

mentioning

confidence: 99%

First experiences with an adjustable gravitational valve in childhood hydrocephalus

Rohde

Haberl

Ludwig

et al. 2009

PED

View full text Add to dashboard Cite

Object The goal of this report was to describe the authors' initial experiences with an adjustable gravity-assisted valve (GAV) called the ProGAV in treating childhood hydrocephalus. Methods The ProGAV was implanted in 53 children (29 boys and 24 girls, median age 7.3 years) with hydrocephalus of various origins. The ProGAV consists of a differential-pressure unit with adjustable opening pressures and a gravitational unit with a fixed opening pressure. Results The mean follow-up period was 15.2 months (range 6–44 months). The authors did not observe any valve-related complications. Four infections (7.5%) occurred, warranting the removal of the shunt. In 19 children, the opening pressure was changed at least once during the follow-up period, for underdrainage in 10, overdrainage in 8, and shunt weaning in 1, with substantial clinical improvement in 18 children. Overall, good clinical results were obtained in 47 (88.7%) of the 53 valve placements. Conclusions With an overall success rate of 88.7%, the first experiences with the ProGAV in childhood hydrocephalus are promising and justify its further use in the pediatric population.

show abstract

Gravitational Shunts in Longstanding Overt Ventriculomegaly in Adults

Cited by 33 publications

References 45 publications

Surgical treatment of long-standing overt ventriculomegaly in adults (LOVA)

Surgical treatment of long-standing overt ventriculomegaly in adults (LOVA)

PROSAIKA: A prospective multicenter registry with the first programmable gravitational device for hydrocephalus shunting

First experiences with an adjustable gravitational valve in childhood hydrocephalus

Contact Info

Product

Resources

About