First insights into the utilisation of the M.BLUE® device for post-haemorrhagic hydrocephalus treatment.

Background/objectives: Gravitational shunt systems reduce the risk of over-drainage in aneurysmal subarachnoid hemorrhage-associated hydrocephalus (aSAH-aH). The Miethke M.BLUE® valve, initially designed for pediatric use, has been scarcely studied in adults. This study assesses its safety and effectiveness in managing aSAH-aH.

Methods: A retrospective study was conducted on 17 adult patients treated with the M.BLUE® valve for aSAH-aH. Outcomes included radiological assessment (Evans' Index, callosal-marginal angle), clinical improvement (gait, urinary, cognitive functions), and post-operative valve adjustments.

Results: The Evans' Index decreased by 14.9 ± 12.2% (P < .001), and the callosal-marginal angle increased by 27.3 ± 21% (P < .001). One case of over-drainage and three of under-drainage required post-operative adjustment. Three non-device-related mechanical complications were recorded (ventricular catheter malposition, peritoneal catheter migration, infection). No valve dysfunctions were reported. Clinical improvements were observed in gait (15/15), cognition (14/15, P < .001), and urinary function (12/13, P < .001).

Conclusions: .The M.BLUE® device appears to be a safe and effective option for treating aSAH-aH in adults. It achieved positive radiological changes with limited post-operative adjustments and demonstrated significant clinical improvements.