• Taro Yanagawa, Yoichi Harada, Keiichi Yamashita, Toru Hatayama, and Takuji Kono.
• Department of Stroke Center, Sagamihara Kyodou Hospital, Sagamihara, Kanagawa, Japan. Electronic address: taro.yanagawa@sagamiharahp.com.
• World Neurosurg. 2021 Oct 1; 154: e770-e773.

ObjectiveThe current study aimed to assess the risk factors and preventive measures for valve inversion after lumboperitoneal shunt (LPS) construction.MethodsThe medical records of patients who were admitted to Mito Brain Heart Center from July 2015 to October 2018 were retrospectively analyzed. Next, clinical and neuroimaging data were collected from electronic medical charts and operative notes. The cause of valve reversal was investigated. In addition, a simulated shunt device was established and the efficacy of countermeasures was evaluated.ResultsThe mean age of the participants was 69.3 (range: 46-88) years, and there were 15 men and 22 women. In total, 20 and 17 patients presented with secondary and idiopathic normal pressure hydrocephalus, respectively. Further, 8 patients had valve reversal.ConclusionsThe distance between the valve and spinous process was found to be significantly correlated with valve reversal. However, the condition can be prevented by fixing the tube at the nuchal ligament.Copyright © 2021 Elsevier Inc. All rights reserved.

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