Novel method for controlling cerebrospinal fluid flow and intracranial pressure by use of a tandem shunt valve system.

OBJECTIVE Programmable shunt valve systems have improved the management of patients with hydrocephalus. However, associated problems such as over-drainage and slit-like ventricles, even in patients with anti-siphon devices installed, still remain unresolved. METHODS We conceived a novel tandem shunt valve system to overcome the problems with existing shunt valve systems. Experiments were performed in vitro and a manometer was used to measure the results. RESULTS Manometric measurements in vitro with the tandem shunt valve system demonstrated that it effectively controlled the final pressure under varying flow rates. This novel system was applied to 2 intractable cases (over-drainage and slit-like ventricles) with good results. INTERPRETATION The tandem shunt valve system has therapeutic potential not only for over-drainage and slit-like ventricles, but also for uncontrollable hydrocephalus, by precisely controlling the cerebral spinal fluid flow rate.