Hydrocephalus (Greek: "hydro" = water, " kephale" = head) describes a pathological enlargement of the fluid spaces (ventricles) in the brain filled with cerebrospinal fluid (liquor). This disease is often the result of other underlying diseases. More information here.
NPH is short for Normal Pressure Hydrocephalus and describes a form of hydrocephalus that usually only occurs after the age of 60 years and is therefore commonly called "age-related hydrocephalus". Due to its specific symptoms and the age of the patients, NPH is not seldom confused with a form of dementia, which leads to the fact that, according to estimates by doctors, every 10th person suffering from dementia actually has NPH and could be treated with it. More information here.
The causes of hydrocephalus can be very diverse. First of all, a distinction is made between congenital and acquired hydrocephalus, whereby congenital hydrocephalus is often associated with brain malformations. There are also many possible causes for acquired hydrocephalus: craniocerebral trauma, cerebral haemorrhages, tumours, meningitis and many more. A special form of hydrocephalus is NPH (normal pressure hydrocephalus).
In general, a distinction is made between hydrocephalus occlusus (occlusive hydrocephalus or non-communicating HC) and hydrocephalus communicans (communicating HC). In the case of non-communicating hydrocephalus, a "blockage" (e.g. tumour) prevents the cerebral fluid from circulating freely between the cerebral ventricles - i.e. from communicating. In the case of communicating hydrocephalus, the cerebral ventricles are freely connected to each other and the cerebral fluid circulates, but there is usually a disturbance in absorption - this means that not enough cerebral fluid is reabsorbed by the venous blood system.
There have been repeated efforts to develop and use drug therapies for the treatment of hydrocephalus, but none of them has really caught on to this day. The therapy of choice still is the implantation of a shunt system or in certain cases an endoscopic intervention.
The duration of the implantation of a shunt depends on several factors and cannot be answered in general terms. As a rule - without any incidents - one can assume 30-60 minutes.
The excess cerebral fluid is usually drained either into the abdominal cavity or into the right atrium, whereby drainage into the abdominal cavity is by far the most common method. The amount of fluid is comparatively very small and is usually very well absorbed and broken down.
All adjustable MIETHKE valves can be checked non-invasively and without X-ray controls for their set pressure level with the associated measuring instrument. We recommend that the pressure setting is always noted in the patient pass, so that you are always informed and can quickly provide information to other attending doctors. For non-adjustable MIETHKE valves, the fixed opening pressure is noted in the corresponding patient pass anyway.
Almost all individual parts of a MIETHKE valve are made of biocompatible titanium. Many more product information can be found online on our website www.miethke.com under the respective products. Our MIETHKE App also shows very nicely the functionality of the valves as well as the pressure stage detection in imaging.
The uniqueness of MIETHKE valves lies in their gravitational technology. It ensures that the drainage of cerebral fluid is regulated depending on the body position, thus taking into account the laws of physics. Different body positions such as lying, sitting and standing are always balanced to prevent frequently occurring symptoms such as headaches. Furthermore, adjustable MIETHKE valves can be individually adapted to the patient and can be readjusted at any time in case of changing life situations.
In addition, all MIETHKE valves are made of biocompatible titanium. This makes them robust, durable, protects the technology inside from shocks and allows the small designs typical for MIETHKE shunts.
A less product-specific difference is the fact that we have been dedicating ourselves full-time to the topic of hydrocephalus every day since 1992.
Unfortunately not yet. It is not so easy for all clinics in over 50 different countries around the world to set up and keep such a Clinic Finder up to date while meeting regulatory requirements in all regions. We are working on it. Until then, however, we can offer that our medical device consultants will personally answer any request for a clinic finder: by e-mail to firstname.lastname@example.org or by phone on 0331 620 830. This applies to the search for suitable clinics in the residential area as well as to individual destinations around the world in the course of holiday planning.
No. In general, each MIETHKE valve has its own measuring and adjusting instruments. However, there are some overlaps, so that some instruments are also suitable for several valves. You can find a detailed overview here.
Here the rule is, as often: What feels good is allowed. What doesn't feel good, is not. And in any case, the suitability for diving - as with healthy people - should be checked with the doctor in advance.
Here we can only report on the collected experiences of patients and as with diving, the answer depends on the patient's personal feelings. There is neither a general recommendation for hiking in high altitudes nor could we recommend certain altitudes which are valid for all patients without complaints. Every person and every hydrocephalus patient reacts very differently to heights and the associated effects on their own body. We have heard of patients who like to hike at high altitudes and do so regularly, and we know of those who have problems with a few hundred metres. You have to try it.
Yes, if you discuss this with your doctor in advance, if you are feeling well and there are no typical pressure symptoms.
No. Nevertheless, we recommend that you always carry your patient's pass with you in order to identify yourself as an implant holder and to have the most important information available to the treating doctor on site in an emergency.