Integra's NPH™ low flow valve.
The automatic, self-adjusting choice for NPH.

Protect aging patients from the ravages of NPH.

Mature patients over sixty, exhibiting gait disturbance, dementia and urinary incontinence may not be suffering from Alzheimer's or other neurodegenerative disorders, but from Normal Pressure Hydrocephalus (NPH). The cause of this debilitating condition is unclear. But many clinicians cite an abnormal accumulation of CSF that dilates and enlarges the ventricles, unnaturally stretching delicate cerebral nerve tissue. NPH does not measurably increase ICP, so unlike most hydrocephalus, it can easily go undetected.

Detection and Diagnosis
When NPH is suspected, it can be identified by clinical assessment, computerized tomography (CT) and/or MRI scans. CSF flow studies and other familiar diagnostic tests can also be used.

The Only Known Treatment
Though the cause of NPH is not clear, the best way to treat it is with a surgically implanted shunt. To date, shunts are the only known effective treatment option for NPH.

The Integra NPH™ low flow valve is a next-generation shunt that's physiologically designed to meet the special outflow needs of NPH patients. It is the only self-adjusting valve that automatically provides a CSF flow-regulation rate of approximately 10ml/hr. and is physiologically designed for the outflow needs of NPH patients. Advantages Over Programmable Valves The Integra NPH low flow valve delivers position-independent performance, without programming or frequent adjustments. The Integra NPH low flow valve offers safety advantages over programmable valves, which can unpredictably readjust themselves and erratically alter flow rates in the presence of magnetic fields, including diagnostic MRI. Integra - Peace of Mind for the Young at Heart Patients who experience difficulty walking, impaired bladder control and/or dementia may incorrectly attribute them to normal aging and not seek medical help. By resigning themselves to their condition, patients' mental acuity and physical abilities can quickly diminish which may reduce mobility and burden family caregivers.

CSF Production in the Elderly
CSF production has been found to be reduced in the elderly population. CSF production rate was found to be 24.6 +/- 14.4 ml/hr in the young (28.7 +/- 4.6 years) and 11.4 +/- 4.2 ml/hr in an elderly population (77.1 +/- 6.3 years), in healthy volunteers.^1,2

DESCRIPTION
The Integra NPH™ Low Flow Valve is an implantable hydrocephalus valve system for controlled cerebrospinal fluid (CSF) drainage from the ventricles to the peritoneal cavity or other appropriate drainage site such as the heart's right atrium. Unlike conventional valves, the Integra NPH™ Low Flow Valve is a variable resistance valve that maintains a drainage at a constant rate, around 10ml/hr, which is within the physiological range of intracranial pressure (ICP). The mechanism incorporates a safety pressure relief mode to prevent accidental intracranial hypertension.

Integra NPH™ low flow valve ordering information

Two Piece Systems (Includes: Valve, 110cm open-ended striped peritoneal catheter, Straight connector and Luer connector.)

One Piece System (Includes: Valve, 110cm open-ended striped peritoneal catheter, right angle guide, Straight connector and Luer connector.)

Burr Hole Systems (Includes: Valve, 15 cm ventricular catheter, 110cm open-ended striped peritoneal catheter, right angle guide, Straight connector and Luer connector.)

Valve Units (Includes built in connectors.)

References:
1. C. May. Cerebrospinal fluid production is reduced in healthy aging, Neurology 40, 1990;
2. M. Czosnyka et al. Age dependence of cerebrospinal pressure-volume compensation in patients with hydrocephalus, J Neurosurgery, 2001, 94:482-486