[Practical value of transcutaneous pressure adjustable valves (Sophy SU 8) in the treatment of hydrocephalus and arachnoid cysts in adults (75 cases)].

The authors report a series of 75 adults treated over the four last years for hydrocephalus (69 cases) or arachnoid cysts (6 cases) by using a transcutaneous pressure adjustable valve (sophy SU 8) the mechanism of which is recalled. The shunt was ventriculo-atrial 46 times, ventriculo-peritoneal 23 times and cysto-peritoneal 6 times. The opening pressure of the valve was initially adjusted 56 times in a medium, 9 times in a high, and 10 times in a low position, according to each particular patient's features. Following the evolution of the neurological status and/or the CT findings, the opening pressure was secondarily modified in 27 patients (i.e. in 36%), and in some of them several times. It was raised 16 times: 10 times because of subdural hydroma(s) (complicated with a subdural hematoma which required a surgical removal, in one case), and 6 times because of clinical symptoms of intracranial hypotension associated with hyper-drainage signs on CT. It was diminished 20 times because of the absence of clinical improvement and persistence of dilated ventricles on CT. In these 27 patients the Sophy SU 8 valve allowed modification of its opening pressure according to the clinical and CT evolution, without need for reoperation. It is concluded that the patients who can benefit the more from this valve system are patients with normal pressure hydrocephalus or with arachnoid cysts.