Premium
Demonstration of a Low‐Impedance Valve
Author(s) -
Turner E.
Publication year - 1962
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.1962.tb03170.x
Subject(s) - medicine , surgery , hydrocephalus , serous fluid
A lthough the use of a Spitz‐Holter valve represented a substantial advance in the treatment of infantile hydrocephalus, many surgeons remain attracted to the method of drainage into a serous cavity. The hard core of the problem is represented by those patients who tend to block tubes and to seal off the ends of them with fibrin or organised connective tissue. My personal impression is that this is often associated with an elevated protein in the cerebro‐spinal fluid, though there is probably a dfference between a rising protein, and a falling one, as might be seen after haemorrhage or an attack of meningitis. Furthermore some cases probably tended to block without the initial examination of the protein showing any abnormality. One advantage of the Spitz‐Holter valve was its action as a subcutaneous pump, clearing the tube. The same principle has been applied to a pump devised by Mr. R. F. Farr, of the physics department, Queen Elizabeth Hospital. This opens under the slightest positive gradient of pressure but acts as a non‐return valve. About 80 such drainage operations are performed a year, and, during the last year, the new valve has been in regular use instead of a straight drainage tube. Fifty such valves have been inserted; at first ventriculo‐laparostomy was performed and during the last five months ventriculo‐thoracostomy has been carried out. Its use has reduced recurrence to a few recalcitrant cases, and it is noteworthy that it is the same cases that tend to come back repeatedly. In the abdomen the tube is placed well away from the parietal peritoneum. The insertion into the chest has not been followed up long enough to make any generalisation about clinical results. The cost is low, and by this I mean the cost to the patient, though the monetary cost is also low. The patient suffers only one or two cutaneous scars, and if for technical reasons the tube has to be replaced, no permanent damage has been done. It is for this reason that the valve is presented at this stage. It is felt that, in its present form, the valve is not suitable for drainage directly into the bloodstream.