The Adjustable proGAV Shunt

Sprung, Christian; Schlosser, Hans-Georg; Lemcke, Johannes; Meier, Ullrich; Messing‐Jünger, Martina; Trost, H. A.; Weber, Friedrich; Schul, Christoph; Rohde, Veit; Ludwig, Hans-Christian; Höpfner, J.; Sepehrnia, Abolghassem; Mirzayan, M. Javad; Krauss, Joachim K.

doi:10.1227/01.neu.0000365272.77634.6b

Cited by 51 publications

(17 citation statements)

References 34 publications

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“…18,57,68,108,110) Lumbar subarachnoid pressure is the most frequently measured 8,10,18,25,31,57,68,96,108,141) ; however, there are also studies measuring parenchymal pressure, 34,35) intraventricular pressure, 110) and epidural pressure. 109,113,127,131) The following 3 items are examined during the measurement.…”

Section: -B-ii Icp Monitoring (Continuous Measurement Of Icp)mentioning

confidence: 99%

“…1) Baseline ICP: The shunt procedure is effective in cases with high baseline ICP, and the threshold is approximately 90-200 mmH 2 O. 10,18,57,68,113) Many cases show pressure that is closer to the upper limit of normal pressure. Conversely, some studies report that there is no correlation between the baseline ICP and the efficacy of shunting.…”

Section: -B-ii Icp Monitoring (Continuous Measurement Of Icp)mentioning

confidence: 99%

“…68) The higher their incidence becomes (more than 15% of all records), the more effective is the shunt procedure. 18,57,113,131) Conversely, some studies report that there is no correlation between the appearance of B-waves and the efficacy of shunting. 31,108,109,141) 3) CSF pulse pressure: Increased amplitude together with decreased latency of the ICP pulse wave are noted in most of shunt-effective cases.…”

Section: -B-ii Icp Monitoring (Continuous Measurement Of Icp)mentioning

confidence: 99%

“…25,31,109) 2) CSF outflow conductance (C out ): Many studies have reported that C out is significantly low in cases for which the shunt procedure is effective, 22,88,113) and the threshold of C out between efficacy and inefficacy was approximately 0.08 ml/min/mmHg (positive predictive value 74-76%). 22,57) …”

Section: -B-iii Csf Dynamics Test (Csf Space Volume Load Test)mentioning

confidence: 99%

“…Since the compliance of the brain is low in iNPH patients, readjustment of the pressure setting is very likely to be required multiple times. 51,57,67) A method to adjust the pressure setting based on the body size of the patient in a sitting position has been suggested. 43,44) Furthermore, there have been reports that the risk of postoperative complications can be minimized by gradually decreasing the pressure setting from high to lower values.…”

Section: -B-i Adjustable or Programmable Valvesmentioning

confidence: 99%

See 4 more Smart Citations

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

Mori

Ishikawa

Kato

et al. 2012

Neurol. Med. Chir.(Tokyo)

551

723

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Among the various disorders manifesting dementia, gait disturbance, and urinary incontinence in the elderly population, idiopathic normal pressure hydrocephalus (iNPH) is becoming of great importance. After the publication of the first edition of the Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus in 2004 (the English version was published in 2008), clinical awareness of iNPH has risen dramatically, and the number of shunt surgeries has increased rapidly across Japan. Clinical and basic research on iNPH has increased significantly, and more high-level evidence has since been generated. The second edition of the Japanese Guidelines was thus published in July 2011, to provide a series of timely evidence-based recommendations related to iNPH. The revision of the Guidelines has been undertaken by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydrocephalus in conjunction with the Japanese Ministry of Health, Labour and Welfare research project on``Studies on the epidemiology, pathophysiology, and treatment of normal pressure hydrocephalus.'' This English version of the second edition of the Guidelines was made to share these ideas with the international community and to promote international research on iNPH.

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Section: -B-ii Icp Monitoring (Continuous Measurement Of Icp)mentioning

confidence: 99%

Section: -B-ii Icp Monitoring (Continuous Measurement Of Icp)mentioning

confidence: 99%

Section: -B-ii Icp Monitoring (Continuous Measurement Of Icp)mentioning

confidence: 99%

Section: -B-iii Csf Dynamics Test (Csf Space Volume Load Test)mentioning

confidence: 99%

Section: -B-i Adjustable or Programmable Valvesmentioning

confidence: 99%

See 3 more Smart Citations

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

Mori

Ishikawa

Kato

et al. 2012

Neurol. Med. Chir.(Tokyo)

551

723

View full text Add to dashboard Cite

show abstract

Gaps, Controversies, and Proposed Roadmap for Research in Normal Pressure Hydrocephalus

et al. 2020

Self Cite

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A BS TRACT: Idiopathic normal pressure hydrocephalus is considered common but remains underinvestigated. There are no uniformly accepted diagnostic criteria and therapeutic guidelines. We summarize the accumulated evidence regarding the definition, pathophysiology, diagnosis, and treatment of idiopathic normal pressure hydrocephalus, highlighting the many gaps and controversies, including diagnostic challenges, the frequent association with neurodegeneration and vascular disease, and the many unknowns regarding patient selection and outcome predictors. A roadmap to fill these gaps and solve the controversies around this condition is also proposed. More evidence is required with respect to diagnostic criteria, the value of ancillary testing, prospective population-based studies and novel trial designs. Furthermore, a need exists to develop new advanced options in shunt technology.

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Normal-Pressure Hydrocephalus Case Report: Self-Documented Over 8 Years with the Author’s Observations

Elsabbagh¹

2016

Acta Neurochirurgica Supplement

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Normal-pressure hydrocephalus is an almost curable disease, but the results of management are still not encouraging owing to the deceptive nature of the disease and its sensitivity to treatment. This has made the management of the disease controversial. The following self-documented report clarifies this. I have reported my experience in a scientific manner so that my colleagues can understand thoroughly certain facts related to intracranial hypertension. Achieving the optimal adjustment of the valve is a real challenge. I describe in detail the adjustment criteria I discovered. I believe that the use of biofeedback waves are almost the best way to make a proper adjustment of the valve, that is, if waves come from this machine and show increased tension of the facial muscles (high spiky waves) the valve adjustment has to be reduced without risking overdrainage. I have been observing my symptoms in some detail, which led me to a better understanding of the clinical pictures related to cerebrospinal fluid changes. I hope that uncovering my story can help with further research and improve management in this important and interesting field.

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The Adjustable proGAV Shunt

Abstract: The proGAV is a safe and reliable device.

Cited by 51 publications

References 34 publications

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

Gaps, Controversies, and Proposed Roadmap for Research in Normal Pressure Hydrocephalus

Normal-Pressure Hydrocephalus Case Report: Self-Documented Over 8 Years with the Author’s Observations

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