This article is part of the supplement: 48th Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida .

Oral Presentation

The use of image intensification in the management of "programmable" shunt valves

R Strachan¹ and R Bore²

¹  Departments of Neurosurgery, The James Cook University Hospital, Middlesbrough, UK

²  Neuroradiology, The James Cook University Hospital, Middlesbrough, UK

author email corresponding author email

from 48th Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida
Dublin, Ireland. 23–26 June 2004

Cerebrospinal Fluid Research 2004, 1(Suppl 1):S2doi:10.1186/1743-8454-1-S1-S2

Published:	23 December 2004

First paragraph (this article has no abstract)

One of the criticisms of the Codman Hakim adjustable shunt valves has been the need to x-ray patients after the valve pressure has been adjusted, to confirm the new pressure setting. Many clinicians complain about the time spent waiting for patients to have their x-ray taken, and of course if the pressure alteration has been inaccurate, a further delay is incurred in resetting the valve, and waiting for an additional confirmatory x-ray. Indeed, the manufacturers of these valves are looking at ways of confirming the valve pressure setting without the need for x-rays. In August 2003, the authors moved to new purpose-built neuro-sciences' accommodation at the James Cook University Hospital in Middlesbrough. With state-of-the-art imaging facilities, including new angiography and image intensification hardware and software, we started to use image intensifiers to assess the shunt pressure setting, alter it appropriately, re-check it and rapidly discharge the patients. The whole process was taking less than 15 minutes. The authors had adopted this process without prior knowledge of any published material. However, despite a publication appearing in the Journal of Neurosurgery in 1997 [1] which clearly described the advantages of using fluoroscopy in this context, this seems to have been largely ignored, certainly within the United Kingdom.