Abstract
Background and objective
The Medtronic PS Medical Strata valve has pressure flow characteristics that are noninvasively adjusted with a magnetic tool. The objective of this study was to examine its efficacy during our initial experience with it in shunt-dependent children.
Materials and methods
A retrospective review of 53 children with a median age of 2.0 years who had 61 Strata valves implanted.
Conclusion
The Strata valve is efficacious in the treatment of shunt-dependant hydrocephalus in children. The 1-year shunt survival rate of 67.2% is comparable to that previously reported from a multicenter trial. Of the 30 therapeutically aimed adjustments during the study period, 16 (53.3%) resulted in improvement in abnormal signs or symptoms. Our data indicate that adjustments can be used to treat signs or symptoms of cerebrospinal fluid overdrainage or underdrainage, which may obviate the need for additional surgery.
Similar content being viewed by others
References
Anderson RC, Walker ML, Viner JM, Kestle JR (2004) Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report. J Neurosurg 101(2 Suppl):222–225
Black PM, Hakim R, Bailey NO (1994) The use of the Codman–Medos Programmable Hakim valve in the management of patients with hydrocephalus: illustrative cases. Neurosurgery 34(6):1110–1113
Davis SE, Levy ML, McComb JG, Masri-Lavine L (1999) Does age or other factors influence the incidence of ventriculoperitoneal shunt infections? Pediatr Neurosurg 30(5):253–257
Drake JM, Kestle JR, Milner R, Cinalli G, Boop F, Piatt J Jr, Haines S, Schiff SJ, Cochrane DD, Steinbok P, MacNeil N (1998) Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosurgery 43(2):294–303
Epstein F, Lapras C, Wisoff JH (1988) ‘Slit-ventricle syndrome’: etiology and treatment. Pediatr Neurosci 14(1):5–10
Faulhauer K, Schmitz P (1978) Overdrainage phenomena in shunt treated hydrocephalus. Acta Neurochir (Wien) 45(1–2):89–101
Foltz EL, Blanks JP (1988) Symptomatic low intracranial pressure in shunted hydrocephalus. J Neurosurg 68(3):401–408
Kestle JR, Walker ML, Strata Investigators (2005) A multicenter prospective cohort study of the Strata valve for the management of hydrocephalus in pediatric patients. J Neurosurg 102(2 Suppl):141–145
Korinth MC, Gilsbach JM (2002) What is the ideal initial valve pressure setting in neonates with ventriculoperitoneal shunts? Pediatr Neurosurg 36(4):169–174
Korinth MC, Weinzierl MR, Gilsbach JM (2003) Experience with a new concept to lower non-infectious complications in infants with programmable shunts. Eur J Pediatr Surg 13(2):81–86
McLaurin RL, Olivi A (1987) Slit-ventricle syndrome: review of 15 cases. Pediatr Neurosci 13(3):118–124
Miwa K, Kondo H, Sakai N (2001) Pressure changes observed in Codman–Medos programmable valves following magnetic exposure and filliping. Childs Nerv Syst 17(3):150–153
Ortler M, Kostron H, Felber S (1997) Transcutaneous pressure-adjustable valves and magnetic resonance imaging: an ex vivo examination of the Codman–Medos programmable valve and the Sophy adjustable pressure valve. Neurosurgery 40(5):1050–1057
Pollack IF, Albright AL, Adelson PD (1999) A randomized, controlled study of a programmable shunt valve versus a conventional valve for patients with hydrocephalus. Hakim–Medos Investigator Group. Neurosurgery 45(6):1399–1408
Pudenz RH, Foltz EL (1991) Hydrocephalus: overdrainage by ventricular shunts. A review and recommendations. Surg Neurol 35(3):200–212
Reinprecht A, Czech T, Dietrich W (1995) Clinical experience with a new pressure-adjustable shunt valve. Acta Neurochir (Wien) 134(3–4):119–124
Reinprecht A, Dietrich W, Bertalanffy A, Czech T (1997) The Medos Hakim programmable valve in the treatment of pediatric hydrocephalus. Childs Nerv Syst 13(11–12):588–593
Rohde V, Mayfrank L, Ramakers VT, Gilsbach JM (1998) Four-year experience with the routine use of the programmable Hakim valve in the management of children with hydrocephalus. Acta Neurochir (Wien) 140(11):1127–1134
Rohde V, Weinzierl M, Mayfrank L, Gilsbach JM (2002) Postshunt insertion CSF leaks in infants treated by an adjustable valve opening pressure reduction. Childs Nerv Syst 18(12):702–704
Sainte-Rose C, Piatt JH, Renier D, Pierre-Kahn A, Hirsch JF, Hoffman HJ, Humphreys RP, Hendrick EB (1991–1992) Mechanical complications in shunts. Pediatr Neurosurg 17(1):2–9
Schneider T, Knauff U, Nitsch J, Firsching R (2002) Electromagnetic field hazards involving adjustable shunt valves in hydrocephalus. J Neurosurg 96(2):331–334
Serlo W, Saukkonen AL, Heikkinen E, von Wendt L (1989) The incidence and management of the slit ventricle syndrome. Acta Neurochir (Wien) 99(3–4):113–116
Yamashita N, Kamiya K, Yamada K (1999) Experience with a programmable valve shunt system. J Neurosurg 91(1):26–31
Zemack G, Romner B (2000) Seven years of clinical experience with the programmable Codman Hakim valve: a retrospective study of 583 patients. J Neurosurg 92(6):941–948
Zemack G, Bellner J, Siesjo P, Stromblad LG, Romner B (2003) Clinical experience with the use of a shunt with an adjustable valve in children with hydrocephalus. J Neurosurg 98(3):471–476
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ahn, E.S., Bookland, M., Carson, B.S. et al. The Strata programmable valve for shunt-dependent hydrocephalus: the pediatric experience at a single institution. Childs Nerv Syst 23, 297–303 (2007). https://doi.org/10.1007/s00381-006-0236-y
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-006-0236-y