{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T22:37:51Z","timestamp":1776465471366,"version":"3.51.2"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,1]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The aim of this study was to establish a standard method for determining the pressure setting of the Codman Hakim valve (CHV) in patients with hydrocephalus.<\/jats:p><jats:p content-type=\"fine-print\">The authors' investigation was twofold. It focused on: 1) the relationships among CHV setting, intracranial pressure (ICP), intraabdominal pressure (IAP), hydrostatic pressure (HP), and perfusion pressure (PP); and 2) the shunt flow in 18 patients with normal-pressure hydrocephalus.<\/jats:p><jats:p content-type=\"fine-print\">With the patient in a sitting position, the pressure environment around the ventriculoperitoneal shunt stabilized when PP became equal to the CHV setting. The lower the CHV setting, the lower the ICP obtained in patients in a sitting position (ICP<jats:sub>sit<\/jats:sub>) settled. This indicated the possibility of calculating the CHV setting by the equation CHV setting = HP + ideal ICP<jats:sub>sit<\/jats:sub> \u2212 IAP, where the ideal ICP<jats:sub>sit<\/jats:sub> was estimated to be between \u221270 and \u2212140 mm H<jats:sub>2<\/jats:sub>O. The CHV setting was individually determined for 18 patients by using this method. The ICP<jats:sub>sit<\/jats:sub> was controlled at a level equal to the estimated ICP<jats:sub>sit<\/jats:sub> in most cases, which supported the rationality of our concept. Shunt flow was intermittent or very low when the patient assumed a supine position and between 200 and 600 \u00b5l\/minute when the patient was seated.<\/jats:p><jats:p content-type=\"fine-print\">Determining the CHV setting by using the equation CHV setting = HP + ideal ICP<jats:sub>sit<\/jats:sub> \u2212 IAP was found to be useful when directly measuring HP and IAP in patients and estimating the ideal ICP<jats:sub>sit<\/jats:sub> to be between \u221270 and \u2212140 mm H<jats:sub>2<\/jats:sub>O. Postoperative shunt control performed using this method was satisfactory, and shunt complications and the number of CHV resettings were lower than in those published in previous reports.<\/jats:p><jats:p content-type=\"fine-print\">Shunt-flow measurement performed in vivo and in real time by using a microflowmeter should be useful not only in testing the functioning of shunt systems, but also in clarifying the pathophysiology of hydrocephalus.<\/jats:p>","DOI":"10.3171\/jns.2000.92.1.0181","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:33:37Z","timestamp":1242236017000},"page":"181-187","source":"Crossref","is-referenced-by-count":53,"title":["New concept for the pressure setting of a programmable pressure valve and measurement of in vivo shunt flow performed using microflow meter"],"prefix":"10.3171","volume":"92","author":[{"given":"Hiroji","family":"Miyake","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomio","family":"Ohta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinaga","family":"Kajimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohji","family":"Nagao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurochirurgie","first-page":"139","article-title":"La valve de d\u00e9rivation Codman Medos programmable. Bilan de 53 implantations chez 50 patients.","volume":"42","author":"Belliard","year":"1996"},{"key":"b2","series-title":"AJNR","first-page":"667","article-title":"Flow-sensitive MR imaging of ventriculoperitoneal shunts: in vitro findings, clinical applications, and pitfalls.","volume":"12","author":"Castillo","year":"1991"},{"key":"b3","series-title":"J Comput Assist Tomogr","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1097\/00004728-199605000-00021","article-title":"Detection of CSF flow in the ventriculo-peritoneal shunt using MRI.","volume":"20","author":"Chang","year":"1996"},{"key":"b4","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1227\/00006123-199002000-00001","article-title":"The relationship between ventricular fluid pressure and body position in normal subjects and subjects with shunts: a telemetric study.","volume":"26","author":"Chapman","year":"1990"},{"key":"b5","series-title":"Neurochirurgie","first-page":"291","article-title":"Int\u00e9r\u00eat practique des valves \u00e0 pression d'ouverture adjustable en transcutan\u00e9 (valve Sophy SU 8) dans le traitement des hydroc\u00e9phalies et des kystes aracho\u00efdiens de l'adulte.","volume":"38","author":"Chidiac","year":"1992"},{"key":"b6","series-title":"Brain","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1093\/brain\/91.4.707","article-title":"Formation and absorption of cerebrospinal fluid in man.","volume":"91","author":"Culter","year":"1968"},{"key":"b7","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1007\/BF00588133","article-title":"Cerebrospinal fluid flow and production in patients with normal pressure hydrocephalus studied by MRI.","volume":"36","author":"Gideon","year":"1994"},{"key":"b8","series-title":"Progress in Research on ICP.","first-page":"73","article-title":"[Intracranial pressure, intra-abdominal pressure and cerebrospinal shunt flow rate in the sitting position]","author":"Kajimoto","year":"1995"},{"key":"b9","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1097\/00006123-199705000-00009","article-title":"A new ventriculoperitoneal shunt with a telemetric intracranial pressure sensor: clinical experience in 94 patients with hydrocephalus.","volume":"40","author":"Miyake","year":"1997"},{"key":"b10","series-title":"[Annual Report of the Research Committee of \u201cIntractable Hydrocephalus\u201d 1997.]","first-page":"27","article-title":"[True normal pressure hydrocephalus\u2014proposal of renewal of clinical entity of NPH and definition in the real pathophysiological aspects]","author":"Oi","year":"1998"},{"key":"b11","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1007\/BF01417677","article-title":"Clinical experience with a new pressure-adjustable shunt valve.","volume":"134","author":"Reinprecht","year":"1995"},{"key":"b12","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1007\/s003810050145","article-title":"The Medos Hakim programmable valve in the treatment of pediatric hydrocephalus.","volume":"13","author":"Reinprecht","year":"1997"},{"key":"b13","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"430","DOI":"10.3171\/jns.1966.25.4.0430","article-title":"The production of cerebrospinal fluid in man and its modification by acetazolamide.","volume":"25","author":"Rubin","year":"1966"},{"key":"b14","series-title":"Childs Nerv Syst","first-page":"454","article-title":"The value of color Doppler imaging in assessing flow through ventriculo-peritoneal shunts.","volume":"12","author":"Sgouros","year":"1996"},{"key":"b15","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1002\/ana.410070603","article-title":"Characterization of clinical CSF dynamics and neural axis compliance using the pressure-volume index: I. The normal pressure-volume index.","volume":"7","author":"Shapiro","year":"1980"},{"key":"b16","series-title":"Acta Chir Scand","first-page":"117","article-title":"A new palliative operation in cases of inoperable occlusion of the sylvian aqueduct.","volume":"82","author":"Torkildsen","year":"1939"},{"key":"b17","series-title":"No Shinkei Geka","first-page":"539","article-title":"[Efficacy and some complications of programmable pressure valve.]","volume":"19","author":"Yonezawa","year":"1991"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/92\/1\/article-p181.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/92\/1\/article-p181.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/92\/1\/article-p181.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T05:12:13Z","timestamp":1679893933000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/92\/1\/article-p181.xml"}},"subtitle":["Technical note"],"short-title":[],"issued":{"date-parts":[[2000,1]]},"references-count":17,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/jns.2000.92.1.0181","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2000,1]]}}}