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.