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Object The lumboperitoneal (LP) shunt with the adjustable PS Medical Strata NSC LP valve and small lumen peritoneal catheter was introduced in the authors' unit in 2007. The object of this study was to audit the unit's experience with this new shunt system. Methods The authors performed a retrospective review of the clinical records of patients who underwent Strata NSC LP shunt insertion. Demographic and clinical data as well as information about complications and revisions were reported. Results Between August 2007 and November 2009, 20 patients underwent placement of an LP shunt with an adjustable Strata NSC valve and small lumen peritoneal catheter at the authors' institution. Their mean age was 40.3 years and the mean duration of follow-up was 12 months. Preoperatively, 18 patients had headache and 15 patients had visual signs and symptoms. Fourteen of the 18 patients with preoperative headache did not complain of headache postoperatively, and 4 had headache that was found not to be related to shunt function. Two of the patients with preoperative visual complaints had ongoing visual problems postoperatively. None of the patients had infection or subdural hematoma. The only overdrainage symptoms occurred in association with spontaneous readjustment of the valve and resolved when the valve was reset. Thirteen patients (65%) did not require shunt revision. Seven patients (35%) required 13 shunt exploration or revision procedures, mainly due to distal obstruction. Placement of an LP shunt failed to completely resolve the raised intracranial pressure problem in 2 patients. Conclusions The use of the Strata NSC valve and small lumen peritoneal catheter is effective in treating pseudotumor cerebri and is beneficial in terms of markedly reducing overdrainage complications compared with other reported series of cases in which an LP shunt has been placed. However, the use of the Strata NSC valve and small lumen peritoneal catheter did not have a marked impact on other causes of shunt failure, particularly distal obstruction.

Treatment Outcomes in newly diagnosed malignant glioma in elderly patients - A 4years retrospective analysis M.S.A Dherijha1, Ali Rajabian2, C.Barrett2L.Alakandy21Salford Royal Hospital, Manchester 2Institute of Neuroscience, Queen Elizabeth University Hospital Glasgow Introduction: The number of GBMs discussed in MDT is increasing as the prevalence of GBM is known to increase with age and overall population is ageing. There are few evidence based established protocols of optimum management of such cases. We aimed to assess the outcome of various modalities of treatments and their combinations. MethodRetrospective analysis of GBM discussed in neurooncology MDT of Institute of Neuroscience Glasgow between 2011–2014 with prospective follow-up. Data included the performance status at presentation and modalities of treatment combinations offered. Outcomes measured by survival time and functional status after aggressive therapies.Inclusion criteria was age above 70.Results: 126 patients were followed M:F ratio 54:46. Median age was 77 (70–90). 35% (n=44) were offered best supportive care due to poor performance, 3% (n=4) had only palliative radiotherapy, 61%(n=78) were offered combined surgery and oncological therapies. That ranged between biopsy alone, debulking and adjuvant chemoradiotherapy. Median Survival rate for best supportive care was 3.2 months, whist for palliative radiotherapy alone was 6.1 months and for combined surgical and oncological treatmentwas 11.6 months. A further 12%(n=16) were not offered oncological therapy after rediscusson in MDT following their surgical intervention with survival of 4.4 months.Conclusion Combined modality treatment clearly has survival benefits even for patients above 70. It can be targeted better by taking into consideration their presenting performance status and other comorbidities in MDT settings.