Ahead of Print: Strategy for Adjusting Programmable Valves

Background: Management of overdrainage complications in shunted patients with idiopathic normal pressure hydrocephalus (INPH) remains a difficult task despite the use of programmable pressure valves (PPVs).

Objective: To assess the usefulness of a quick reference table (QRT) algorithm for achieving a suitable initial PPV setting in INPH patients who participated in the study for INPH on neurological improvement (SINPHONI).

Methods: One hundred registered patients diagnosed with probable INPH were treated with ventriculo-peritoneal shunts (VPS) using Codman-Hakim programmable valves (CHPV). In this series, the initial CHPV setting was decided prospectively according to the QRT algorithm. Shunt effectiveness, complications, and the number of CHPV readjustments during follow-up periods were investigated.