Because one cannot know in advance which case will turn out to be complicated, the authors' preference is to use the Codman Hakim programmable valve for all conditions in which CSF should be drained.

Noninvasive, particularly consecutive, minor or single larger adjustments to the valve opening pressure can further improve outcome in patients with NPH who undergo shunting.

Seventeen patients treated with ventriculoperitoneal shunt (VPS) for idiopathic intracranial hypertension (IIH) were followed up for 1.8 to 12.8 years (mean 6.5 years). The ventricular catheter was inserted without any guidance device. VPS was effective on all clinical manifestations of IIH. Seven patients required one or two (a total of nine) surgical revisions. The revision rate was significantly less than in two similar series of patients treated with lumboperitoneal shunt.

Adjustment of the valve's opening pressure further improves outcome in pediatric patients.

there is a metabolic response to carotid cross-clamping when no shunt is used. However, the clinical significance of this is unclear, since there were no intraoperative strokes.