MIETHKE GAV, Patient Handbook

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| PATIENT HANDBOOK
GB
THE COMPANY
Christoph Miethke GmbH & Co. KG is a Branden-
burg-based company that develops, manufactures
and markets innovative neurosurgical implants for
the treatment of hydrocephalus. In this, we work
in successful partnerships with numerous hospitals
worldwide.
The purpose of this booklet is to provide you and
your family with some understanding of the treat-
ment of hydrocephalus. The successful treatment
of this condition has only been possible since the
1950s. In a dramatic race against time to save the
life of his son, Casey, who suffered from hydroce-
phalus, a technician named John D. Holter deve-
loped, in only a few weeks, a novel silicone valve.
Despite the fact that, since its first implantation in
March 1956, this valve has proven to be clinically
effective and a giant step in the treatment of this
condition, there are many patients today who ex-
perience considerable problems with hydrocepha-
lus valve systems.
Christoph Miethke picked up the knowledge gained
in 50 years of valve treatment and developed a
new generation of highprecision valves made of
the metal titanium. For the first time, there are valve
systems available that consistently take into ac-
count the physical conditions of brain fluid drai-
nage and can thus maintain a physiological brain
pressure, independent of the body position of the
patient.
Fig. 1: Anatomic sketch of the cranium (inner cover page)
1) skull pan
2) brain
3) cerebrospinal fluid
4) lateral ventricle
5) third ventricle
6) fourth ventricle
BASIC ANATOMY
The human brain (fig. 1) is surrounded by a spe-
cial fluid known as cerebrospinal fluid (CSF). Ce-
rebrospinal fluid is produced in several chambers,
so-called ventricles, that are found within the brain.
The channels, by which the ventricles are intercon-
nected, constitute a complex drainage system.
The fluid in the brain circulates through these
ventricles and eventually flows into the venous
blood. The function of this fluid is to protect the
brain from mechanical damage. The CSF also
regulates the internal brain pressure (intracranial
pressure, ICP), keeps the brain tissue moist and
transports the products of metabolism.
CLINICAL PICTURE OF THE CONDITION
In healthy humans, a balance exists between the
production and resorption of cerebrospinal fluid.
In infants, approx. 100 ml of this fluid is produced
every day; in small children, the daily production
is approx. 250 ml, in adults approx. 500 ml. If the
amount of fluid produced exceeds the amount re-
sorbed, the ventricles expand, leading to the con-
dition known as hydrocephalus (fig. 2). The term
hydrocephalus refers to the continuous increase
of the volume of “water” (hydro) in the “head” (ce-
phalus). This condition is often observed at birth
(congenital hydrocephalus), but it can also deve-
lop later in life, e.g., as the result of inflammation,
hemorrhage or severe head injury, or after brain
surgery. Such cases are referred to as acquired
hydrocephalus.
A further distinction is made between obstructive
hydrocephalus and communicating hydrocepha-
lus. In obstructive hydrocephalus, the links bet-
ween the ventricles of the brain are interrupted
so that the ventricles cannot “communicate” with
each other. Cases in which the ventricles are in-
terlinked through open channels, but resorption of
cerebrospinal fluid is impaired, are diagnosed as
communicating hydrocephalus.
a) b)
Fig. 2: Ventricle size
a) normal, b) hydrocephalus