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Arq Neuropsiquiatr. 2013 Apr;71(4):229-36.

Programmable valve represents an efficient and safe tool in the treatment of idiopathic normal-pressure hydrocephalus patients.

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Neurosurgery Residency Program, Department of Neurosurgery, Hospital do Servidor Público Estadual de São Paulo, São Paulo SP, Brazil.


Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbance, dementia and /or urinary incontinence, dilation of the ventricular system and normal opening cerebrospinal fluid pressure. Shunt surgery is the standard treatment of iNHP. Diversions with programmable valves are recommended, once drainage pressure can be changed. However, well-defined protocols still lack guiding the steps to attain proper pressure for each patient.


In our study, we reported the experience of shunting 24 patients with iNPH using Strata® (Medtronic) valve, following a protocol based on a positive Tap Test.


We observed clinical improvement in 20 patients and stability/worsening in 4 patients. Complications occurred in five patients, including one death. The results display improvement, and complications occurred at a lower rate than reported in other studies.


The Strata® valve used in the proposed protocol represents an efficient and safe tool in the treatment of iNPH.

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