Adjustable hydrocephalus valve

Adjustable Hydrocephalus- valve

The invention relates to an adjustable valve for Hydrocephalus

Pressure equalization of Liqor intracranial hydrocephalus patients.

Hydrocephalus patients have the following medical problem:

The brain is in the skull, surrounded by a special fluid, the cerebrospinal fluid. This CSF is constantly produced and absorbed to the same extent. When the disease of hydrocephalus, also called water on the brain, this balance is disturbed, and it is more liquid produced when is degraded. Since the intracranial space is a closed vessel, there is an increase in volume. In infants, the cranial sutures can not grow together, the adult of the intracranial pressure rises. So there is an age and Kinderhydrocephalus.

The treatment of hydrocephalus originally done by the mere

Derivation of cerebrospinal fluid. This was done by the mere hose connection between the skull and a large venous blood vessel or through a corresponding compound of the skull through a hose to the

Abdominal cavity. Soon it became evident that the pressure in the skull must have a certain physiological value, if not to other complications occur again.

Various valves are known which are installed in the drain pipe for the liquor and is set with the aid of which the pressure of cerebrospinal fluid. Such valves are implanted in the head under the skin. The valves are to be opened at a certain critical pressure and the provide drainage of cerebrospinal fluid free. Via a line - also implanted under the skin - the liquor is drained into the superior vena cava or the abdominal cavity.

Although the known valves are already helping significantly.

A satisfactory solution has not yet been reached with the known valves.

There is a lack of adjustment to the individual patient, ie. On the respective application

There are already known valve developments that allow adjustment. It is to valves which are implanted into the patient and preferably also implanted through a hose line the

excess cerebrospinal pull out of the patient's skull and

preferably derived in a vena cava or into the abdominal cavity. Here, the valve pressure is determined by a spring, wherein the spring is adjusted by one having a pivoting movable or rotationally movable part which is moved from the exterior by pivoting or turning the magnet, so that the spring is tensioned or relieved.

The known valve having a flattened construction. Target of flat construction is to prevent possible bumps on the patient's head during implantation.

Among the known valves as part of the Codman Medos valve. This valve is a ball valve with a spring-loaded ball. The

Valve is adjusted by changing the spring position. The spring presses with one end on the valve ball. With the other end of the spring is supported on an abutment. The abutment is adjustable in height for this type of rotation. The height adjustment is achieved by the abutment is pivotally mounted and is topped with a slanted or stair-like step-extending edge on which slides the spring. The adjustment of the abutment is a

Abutment pivoting motion of no more than 180 degrees is limited.

This leads to inaccuracies in the setting. In addition, a small unintentional pivotal movement of the abutment already

significant valve changes drove can.

Among the known valves also includes Sophysa- valve.

Even the manufacturer of this valve has concerns when the Hydrocephalus- patient comes with permanent magnets in toys, headphones, speakers, electro-magnetic fields in contact, such as those produced by electrical motors, razors, hairdryers, switches etc. These

Warning the manufacturer includes a warning against most

Of life of people. As a man of the contemporary burden with such things can not escape, such solutions are not practical.

Specifically, reference is made to the prior art:

DE600024437T2; DE60315924T2; DE29725762T2; DE69808558T2;

EP41421557B1; EP688578B1; EP1243826A2; EP1457231B 1; EP1604703B1; EP1642613B 1; EP255227B1; EP2420284A2; US4443214, US4540400;

US4551 128; US4673384; US4769002; US5843013; US6840917; US8298168; US2005 / 0055009; US2012 / 0197178; US2012 / 0302937; US2013 / 0066253;

US2013 / 0,085,441th

Meanwhile, there have been some efforts to improve valves. This includes DE10358145. This proposal continues the known

Construction firm and has set itself the task of increasing the safety of such valves. According to DE 10358145 a higher safety is achieved in two ways. One path includes a special adjustment of the spring. In this case, a particularly large adjustment range is provided, which in a change of the

Spring loading is stocky. That is, at a comparable

Changing field of spring loading, a larger adjustment is provided. In the extent to which the adjustment is greater, will reduce the risk of undesirable reproduced above adjustment.

Advantageously, at the same time increases the accuracy of the adjustment with increasing displacement.

The other way for greater safety will be opened by DE 10358145 by a solenoid-operated lock.

The possibility of larger design of the adjustment is obtained by changing the position of the spring. According to DE 10358145, the spring is placed so that the plane of movement of the spring in its displacement is parallel to the plane in which the pivotal movement or rotational movement of the

Pivoting part / rotor takes place. The parallelism is also given when the planes coincide.

The special arrangement of the spring, the spring can move in the direction in which the valve housing extends furthest. This is the direction of the flat side.

Preferably place as a spring, a spring rod application, the

is pivotally mounted, and one end of which is longer than the other end. The shorter end communicates with a valve ball or valve cover of the valve in operative connection, the longer end enables the larger

Displacement and cooperates with the adjusting mechanism described. In this case, a sliding, known per se, operative connection between the spring and the rotatable or pivotable part is provided. That is, the spring slides on a face of the rotationally movable or

pivotable part of the adjustment mechanism.

Conveniently, the use of a spring bar which is designed as a double lever arm. The double-arm lever is hinged.

The operative connection with the valve ball or the valve flap is formed by the soon end sliding against the valve ball or

Valve flap presses.

The operative connection with the Verstellmechnik is formed in that a sliding surface is provided for the shorter lever arm to the rotatable or pivotable part / rotor which is designed as a curved path on which the spring rod slidably abuts.

The curved path runs after DE10358145in circumferential direction and in the radial direction to the pivoting or rotary member. Of the

Circumferential angle of the pivoting or rotary member comprises in particular at least 300 degrees.

The valve pressure limiting spring can slide on the cam track in a pivoting direction / direction of rotation or in both pivoting directions / direction of rotation. The direction results from the direction of rotation or

Pivoting direction of the rotatable or pivotable

Schenk part / rotor.

Optionally, the rotatable pivot member / rotor are moved in the same rotational direction and yet again at the

Verstellanfang come. This is achieved in that between the start of the curve path and the end of the cam track on the rotatable or pivotable part is a compound provided.

The pivotable or rotatable swivel part / rotor sits on a shaft / pin / pin, which is integral with the flexible lid or bottom of the housing. With the axis / pin / pin the Schenk part / rotor is in

rotatably or pivotally mounted housing of the valve.

The sliding on the pivoting part Schenk / rotor, the valve pressure limiting spring preferably has an angular shape. The two lever arms of the double-armed lever arm to each other at an angle which is preferably smaller than 180 degrees, can also be smaller than 90 degrees.

The cross section of the valve spring pressure determined may be arbitrary. Favourable are round and rectangular shapes. It is particularly favorable spring with a leaf-shaped or wire cross section.

For pivoting or rotatable mounting of the valve spring pressure defining suitable as a pin / axle / bolts, grab the ends into corresponding recesses in the valve body or the valve cover or valve tray. The ends of the pin can also be configured pointed, so that the pin rotates in the recesses on the tips. These

Procedure is technically and economically favorable.

To attach the pin to the spring itself is a welded or

Solder, other compounds.

For the function of the valve pressure defining spring is favorable when the long lever arm of the pivoting part and rotatable Part (pivot part / rotor) of the adjustment mechanism is performed. Given this pivotal part / rotor can also at least one side drove the valve pressure defining spring. On the other hand, the guide can be used to

Example, by a pulley or by a membrane or by a

Housing cover or housing bottom are formed.

Valve ball side it is favorable if a large area of ​​contact between the valve pressure defining spring and the valve ball will take place. To the extent that the valve pressure limiting spring will not accommodate this large area of ​​contact, at the end of the spring in question a sheet can be attached. The sheet is optionally welded or soldered or secured in any other way.

The pivoting part / rotor is usually moved by magnets embedded in the rotor pivot member. The pivoting part / rotor magnet and the spring pressure limiting spring, hereafter

Adjustment mechanism of the implanted valve indicates. an adjusting device is to move the valve pressure on the outside of the patient's skin is placed, which is also provided with magnets. These magnets of the outside mounted adjusting device acting on the magnets of

Pivoting part / rotor in the implanted valve, so that a

Rotation / V erschwenken the external adjustment device a

Rotation / V of erschwenken arranged in the implanted valve

Pivoting part / rotor causes. Followed by a pivoting of the

Valve pressure defining spring, associated with a change of

Valve pressure.

Since the 90s it is known that the adjustment mechanism also

can be moved unintentionally when the patient can reach the area of ​​influence of strong magnetic fields. This has led to the desire to lock the adjustment mechanism in each position. There are known for interlocking various proposals.

Known proposals to use for the lock again Magnets.

Use different proposals for the locking spring forces and

Frictional forces.

Enforced previously have two suggestions.

In one proposal, a casing presses in the locking state with cam frictionally to the rotor pivoting / swiveling part, which carries the inclined surface or step-shaped stepped surface. At the spring described above slides. To unlock the housing must be so warped that the cam lift of the rotor / swing member. After this

Lifting of the cam, the rotor / pivot member can be pivoted with an external on the skin of the patient adjusting device. These

Adjusting device has magnets that interact with other magnets together, arranged in the rotor / swing member.

In another proposal, the spring force of a domed will

Housing cover used for locking. The lid pulls the

Rotor / swivel part with its resulting from the camber force against them, so that in the locked state arises frictional engagement of the rotor / pivoting part to the housing cover. Here sits the rotor / swing member

rotatably / pivotally on one of the housing cover

provided axis / pin.

For unlocking the housing cover is deformed such that the

Rotor / pivot member apart from the housing cover, no frictional engagement exists for the cover and can be pivoted with the aid of an externally placed onto the skin of the patient adjusting device. The Adjusting device has magnets which are embedded in the pivot part / rotor.

The rotatable swivel part / rotor is depending on

Rotation / pivoting direction, the sliding on the pivot part / rotor, the valve pressure limiting spring tensioned or relaxed. The determining the valve pressure spring slides on a cam track of the

Pivoting part / rotor. At the same time the valve pressure-determining spring presses presses on the valve ball of the valve, so that it is desired to

Change the closing pressure of the valve ball or the valve coming.

The ball valve cooperates with a conical opening in the housing of the valve. This port is located on the inlet side of the valve in DE10358145.

As magnets preferably find small sizes, for example,

Pin magnets use. The small magnets also contribute to small valve dimensions.

The externally provided on the skin of the patient adjusting device for the valve can be also designed with extremely small dimensions. According to DE 10358145 is to reduce the diameter of the

Adjusting device and to a special shaping of the

used adjusting device, namely the design of the adjusting device in stick form, similar to a pen. This allows the handling of the adjusting device as the handling of a pin or pen, z. B by carrying it in a breast pocket. At the same time, the mechanism is a

Pen used to the laid down at the head of the adjusting device magnets longitudinally of the pin before (in an attached pen against Head of the patient or to the valve) or to move back. In a vertical position of the pin which is raised and lowered.

Optionally, has the pin-shaped, externally fitted to the patient's skin adjustment device at the front end a cap with the

Adjusting device is placed. For loose placement of

Adjusting device to cause automatic centering of the adjusting device on the rotor / swing part of the valve that the magnets.

After the centering of the adjusting device arranged outside of the patient to the implanted valve is an elastic deformation of

implantiertenVentils provided for the purpose of unlocking the pivoting part / rotor. Then, the adjustment described above is performed.

The technique described in DE 10358145 has been proven.

Nevertheless, the invention has the task of improving the technology. The invention of the knowledge is assumed that the valve and its operation could be improved.

According to the invention this is achieved with the features of the main claim and in a preferred embodiment with the features of the subclaims.

It should be emphasized that the valve in the unlocking and / or locking of a signal. It can also signals to control the position of the rotatable or pivotable pivoting part / rotor can be used. The signals can be acoustically and / or optically and / or electronically, or felt. With the signals a high security for proper placement of the adjusting device is provided. can be resolved only through proper placement, which have position the valves and currently

then the correct change of position to be made. Optionally come solid state switches are used.

When solid state switches the signal may be generated by choice of optical and / or acoustic form or as-felt signal. This includes a remote transmission of the signal generated in the subcutaneously arranged valve to an external signal receiver and signal conversion in the external signal receiver.

When solid state switches passive transponder in the valve of particular advantage can be. The passive transponder responsive to signals that are input from the outside, and then give of itself a signal to the outside.

Preferably, the signal is generated mechanically. Clicking sound is even more preferably produced. The clicking noises occur, for example by use of spring steel or other elastic material, which is brought to a sudden buckling pressure, so that a sound is.

The clicking noises occur, for example by using elastic material with a relatively high deformation force or high relative

Restoring force. However, the nature of the material is preferably selected so that a manual operation can take place. The selection includes not only the material itself, but also its shape. The higher the strength of the material, the thinner the material can be chosen to allow the operation by hand. Preferably, the spring plates with a thickness of at most 0.5 mm, further at most 0.4 mm and most preferably not more than 0.3mm preferably chosen. According to the invention, the elastic material is brought to the deformation and then suddenly given free, so that can continue to deform the material abruptly or back deform very much dependent on the type of deformation. As the material any biocompatible elastic material comes into consideration. These include metals as well as plastics, also composites. Optionally pass the spring plates of the same material as the valve pressure

determining spring. Preferably is titanium (titanium alloy) for the spring plates application.

Because there is no everlasting absolute elasticity, are only those

materials find application, the permanent over the lifetime of the valve by the deformation according to the invention at most 50%

Learn deformation, preferably not more than 30% permanent deformation and more preferably more than 10% permanent deformation, and most preferably at most 5% permanent deformation, the% figures relate to the extent to which the reshaping after the last

reduced noise forming deformation of the spring steel during the lifetime of the valve opposite the rear deformation after the first noise-forming deformation.

Preferably, sheet-shaped material made of titanium (titanium alloy) or of the same metal is selected from the also the housing of the

Hydrocephalusventils there. This material is biocompatible. For the

Spring plates made of titanium or of the same metal as the housing, the valve applies to the elasticity / permanent deformation of the same as for spring steel sheets.

Optionally find rod-shaped or leaf-shaped springs / spring plates for the noise-forming deformation application. On the shape of the Springs / Spring leaf also has influence as the noise-forming deformation is generated.

The noise-forming deformation, a simple bending or

be rebound after a simple bending. Here, the leaf spring may have a flat or a different output form before the bend.

Preferably, an indentation of the leaf spring or a

Rebound of the spring leaf of a dent used as a noise-forming deformation. Here too, the leaf spring may have a flat or a different output form.

For the deformation of the leaf spring, a corresponding room must be provided in the valve available. It is of advantage when the spring blade a

is part of the valve housing. Preferably, the leaf spring simultaneously forms the valve cover. In this case, the material forming the valve cover spring leaf can also be referred to as a membrane. The valve cover is according to the invention does not always overhead valve member, but still the part of the implanted valve that is implanted in the patient that its valve cover with an externally placed onto the skin of the patient adjusting device

corresponds. In this case the valve is not at an implantation under the

The patient's scalp bound. Even if the regular

Implantation site, the valve can be implanted at a different body site.

Optionally, the resilient leaf forms only an accessory for a valve.

Preferably, a circular leaf spring is provided with Beulstruktur as starting shape, which is pressed by hand. Even more preferred is the Beulstruktur forming the initial shape, has been produced by cold deformation.

Circular spring leaves, which are pressed, are known to Hydrocephalusventilen. However, the known spring blades cause no noise.

For the noise, a stress condition in the spring leaf is decisive, with the bulge in the spring blade which is pressed by hand, resulting in contrast to the depression of a flat spring leaf a special force-displacement curve. When pressing the curve initially rises. The resistance against the pressing due to the einzudrückenden Beulstruktur grows stronger as in the forming of a flat spring leaf. At exceeding of a certain force, and reaching a certain

Deformation state falls the line sharply and abruptly. The force-distance characteristic curve bends and this creates known in mechanics

Druchschlag effect. That is, the leaf spring hits on the other side, and outputs an audible and tactile noise, which is referred to as cracking. This effect is used in toys, the so-called cracking frogs. The penetration is also felt. This effect is also used when dressing / skinpass of animals. There, the devices are called clickers.

In art, this noise is even with snap-action switches,

Known folding switches and toggle switches. It is not the noise but the sudden touch of the buttons is sought in order

To prevent current spikes from the switching operation.

With the penetration of the leaf spring is formed on the opposite side of the spring blade a bump.

After ending the load, there are two options: a) In one variant results in a stable condition. The bump remains after the breakthrough on the side on which it arose. That is, the leaf spring has two stable states Beul, the bump before the deformation and dent after deformation. To come back after deformation to a rebound, a mechanism is preferably provided with the bulge can be pushed back. With the mechanics of a counter-pressure against the resultant bump can be generated, which

sets rebound in transition. Optionally, to the axis on which the pivoting part / rotor sitting and acting on the axle spring can be used. In addition, the pivoting part / rotor may also be used for the return deformation. This is especially true for the case where the pivoting part / rotor for

Locking is brought frictionally into contact with the valve cover, and when the adjustment part / rotor with the associated axis of a spring in the direction of the valve cover is pressed, which is independent of the valve cover. Then this spring, although when unlocking

compressed. During locking, the pressure is, however, put back of said spring, because outsiders on the patient's skin

Adjusting device is removed. Then the spring can not only the

cause locking operation, but also abut the left by the first deformation process bump to rebound. The offense must not be exercised by the force long, which is required for the first deformation process.

In the spring leaf is by the first deformation process a

Stress state emerged which significantly supports the rebound. It is advantageous if the spring leaf is formed as a corrugated membrane as described in PCT / EP201 1/003903. Even cheaper

Voltage conditions arise when the spring blade circular and in a permanent form has been deep-drawn, forming a stepped bulge. The Beulstruktur invention has the further advantage of additional spring property, greater stability and greater strength, so that even a somewhat eccentric introduction of force during unlocking and adjusting the valve is harmless.

Moreover, the sound of a resounding erflndungsgemäß corrugated or stepped thermoformed spring leaf as the sound of a resounding ungraded / uncurled spring leaf is felt comfortable.

In addition, the force in the Rückvorverformung, which was required in the first deformation to the press-causing frictional engagement with the locking spring is dispensed together.

Advantageous for the rebound is also when the housing cover is of two shells, the outer shell forming the above-mentioned leaf spring and the second, inner shell limits the deformation of the first, outer shell / spring leaf. This limitation can also be referred to as an abutment, because the first shell in the first

Deformation of the second, inner shell creates.

Preferably, the deformation of the outer shell is terminated immediately after the generation of noise by means of the second inner shell. This also reduces the required for the abutment of the rebound spring force.

Advantageously, the rebound ends likewise under

Noise. This provides additional security at the right

Valve adjustment. b) in the second variation is otherwise the same training as in the variant a) a leaf spring with a cold molded, lasting Beulstruktur used. The spring leaf of the variant b) is different from the spring leaf of the variant a), characterized in that the spring leaf none contention required in order to regress after completion of the deformation. This is attributed to the fact that the voltage produced by the cold deformation

together with the stresses resulting from the impressions of Beulstruktur are large enough to cause the deformation automatically reset, however, but still show the effect of the noise-forming strikethrough.

This leaf spring has the advantage over the leaf spring according to variant a) that it facilitates the task and for any plastic deformation caused by accidental operation or a reserve safety features that the spring leaf regresses in the desired shape. This spring has been tested with a load of 10kg. More can not cause accidentally by hand a physician during the adjustment of the valve pressure. As a result, the first outer shell of the housing cover, which forms the spring leaf has indeed plastically deformed. The force-displacement curve has changed so that the first shell of the housing cover has produced with less force than before a noise, but it still provides the desired release and has again regressed so far to the relief that the lock held and subsequent locking and unlocking operations were not disrupted.

The invention bivalve valve cover can also with the

A one-piece valve housing or be a welded to the valve housing part. Preferably, the bivalve valve cover is a

cup-shaped portion of the valve housing is formed or forming the valve cover with a portion of the valve housing a pot shape. Still more preferably, the cup shape is made up of several parts. This includes a annular portion of the valve housing and the two bowls of the bonnet. The two shells may be welded to the annular housing portion or be connected in other ways.

Before welding the two shells are brought into the desired shape. This can be done by pressing / deep drawing of a flat material. For the desired stress state is a pressing / stamping in the cold state of advantage.

The deformation of the starting material for the shell of the valve cover can be held in one or more steps / stages. In a multistage

Preparation is preferably first produced a concentric wave structure in the plane or with small differences in altitude before in a second step takes place in a final three-dimensional deformation.

For the deformation preferably a press is provided. There are

mechanically operated presses, hydraulic presses and with compressed air

operated presses. Here the desired pressing force is low, because the

Spring leaves are small and thin. Therefore, can be applied here also hand-operated presses, especially toggle presses.

The dies are made of female and male. There are for each

Deformation stage separate female and male provided, so in the case of a two-stage deformation process for the first working step, a pair of male and female parts and the second deformation step another pair of female and male.

In molded outer shell which forms the abutment inner shell of the outer shell is preferably adapted. The required shape must not resist giving the shape of the outer shell is identical. It is connected sufficiently and with less effort when the inner shell is provided with flat steps on which the outer shell with their bulges to Conditioning comes. Advantageously, an inner shell serve as an abutment for different outer shells.

The Zweischaligkeit on the valve housing is independent of the

Noise like, regardless of advantage that the shaft on which the pivoting part is seated is connected to the housing lid or forms a separate component.

The valves according to the invention preferably have a diameter of 8 to 20mm, even more preferably up to 15mm.

Optionally, the size of the spring Plattes geared to the size of the valve. but it can also be a spring leaf of uniform size for the valves

be used. Then the spring blade is introduced in larger valves in the valve cover.

The thickness of the leaf spring is preferably selected according to the diameter and on its size. Spring leaves for a valve having a diameter of 17mm, a thickness of for example less than / equal to 0.2 mm, even less than / equal to 0.16 mm may have. With decreasing valve diameter and a correspondingly smaller spring sheet the thickness is less / equal than 0.15mm.

Whether and which deformation is to receive the leaf spring depends on its function. As far as the spring sheet is only determined in bivalve training of the valve cover to unlock the adjustment mechanism, all it takes is a very small stroke of the leaf spring to the frictional engagement between the pivot part annul / rotor and the valve cover. With good quality valve can be 0.1mm or less, the required stroke. A longer stroke than 0.3mm is regularly required. For a small stroke the spring leaf must not be dented. With Hub is in the buckling of the invention, the greatest distance between the two shells of a bivalve valve cover training referred. At the site of the largest deformation takes place when pressing the

Valve cover instead. With single-shell valve cover training with stroke also the largest deformation of the bonnet denoted.

For an inventive application of the bivalve construction for

Generating a clicking sound is regularly a larger stroke is required, for example for a valve diameter of 17 mm, a stroke of at least 0.4 mm. Depending on the diameter of the valve and size of the leaf spring and depending on the desired noise and depending on the level of

By hitting the Beulstruktur a larger or smaller stroke is required. When noise are the wishes of the patient and the

to consider perception of the treating physician. The noise is lower, the lower is the hub. In addition, a wavy Beulstruktur have a dampening effect on the noise.

the stroke of the outer shell 0.3 to 2 mm is preferable.

The desired stroke determines the degree of permanent Beulstruktur.

There are various ways to produce the lasting Beulstruktur. In the preferred two-stage cold forming with the embossing of the

Waveform / camber shape in the first molding step and the

final three-dimensional deformation of the leaf spring is deformed beyond the desired permanent deformation addition, to reflect the elasticity of the spring leaves account. The thinner the material used for the spring leaves, the gentler to the spring blades are deformed. This includes preferably that the spring leaves are no longer pressed into the second deformation stage but only deep-drawn. In the deep drawing, the spring blades are clamped at the edge and with a corresponding Molding bulged, so that the material in the area of ​​the permanent deformation can flow extremely well.

For an application of bivalve bonnet with Beulstruktur without generation of noise can be eliminated all restrictions that are associated with the generation of noise. This concerns in particular the limitation of the stroke for the sake of noise attenuation.

Nevertheless, it is of such a valve or a signal because the

Yielding of the outer shell of the valve cover for the physician can be felt.

Advantageously, the valve cover can also be provided in single-skin construction with the above Beulstruktur. Then, however, the valve cover is provided with a thickness such that (without an abutment) he alone holds the charges arising from the pressing state. The invention

Beulstruktur unfolds advantages in this application.

It is also advantageous if the pivot part / rotor unlike after

DE10358145 sits on an axis / pin / pin, which on the flexible for locking and unlocking of the swiveling part / rotor valve covers forms a separate component in relation, which is held displaceably in the longitudinal direction in the valve housing. The additional movable support in

Longitudinally appear more complicated than the one-piece with a valve cover design, at first glance. A closer look at the separate education has particularly when combined with an up to

Noise suddenly bulging valve Eckel however constructional

Advantages. In addition, the valve wins with the movable storage nor accuracy advantages and operational reliability. Furthermore, opening up with the use of a separate from the valve cover axis / pin / bolt is a locking pressure independently generated by the case deformation.

According to the invention, the locking pressure is additionally provided with a

produced spring provided. For this additional spring different springs come into consideration. Preferably it is a spiral spring which sits on the axis / pin / pin, with which the pivoting part / rotor is guided. The spring has the advantage of a simpler design of the locking pressure. In addition, the locking pressure can be easily changed by adjusting the length of the spring or by substitution of the spring.

For the locking and unlocking is a little stroke of

Axis / pin / pin required. Preferably, the stroke is limited.

To limit the axis / pin bolt with a ring or collar may be provided. The ring is pressed, for example. The covenant is with the axis / pin / pin, preferably integrally.

The ring or collar cooperates with a stop in the housing,

Preferably, the movement of the axis / pin / pin, on which sits the pivoting part / rotor is limited by the valve bottom, which is the valve cap on the valve opposite. To the same time can reduce the frictional forces between the valve base and the axis / pin / pin this

its valve on the bottom side provided with a tip.

Preferably, the pivoting part / rotor is provided, moreover, with markings that by X-ray information about the location of the

enter pivotal part / rotor. The information can also be generated by signals which are produced as the signals for locking / unlocking. By X-ray or other signals can be clarified in doubt whether the valve has been implanted right or wrong. These are

Marks, which look different when X from one side than from the other side.

When marks are also holes in the pivoting part rotor when the holes are arranged in a distinctive way, and if the

Holes with certain other peculiarities in housing

distinctive way related. Such housing may feature a stop for the pivoting part / rotor or a special feature on

Valve inlet or at the valve outlet. The labels may, regardless of the generation of noise according to the invention and also independent of the above-described embodiment according to the invention / storage of the

Pivoting part / rotor can be found in other types of Hydrocephalusventilen application.

In the valve according to the invention optionally also a limitation of the swivel angle is provided. To limit the pivoting movement of bolts or pins or other abutments may be provided in the housing.

Optionally, opposite the DE 10358145, more than two magnets, for example, four magnets provided on the rotor. This increases the adjustment force on the rotor considerably.

Finally, it is also advantageous if dead spaces eliminated in the valve

werden.Toträume are cavities in which the liquor flows in comparison to other cavities at a low speed or even stands. There easily form clots. The dangerous cavities are eliminated by filling in the area of ​​the base or lid. Preferably, the cavity is so far completed, that the flow area between the Liquoreintritt and the CSF leak in the center is not greater than 10 square millimeters, even more preferably on average is not greater than 7 square millimeters, and most preferably on average not greater than 4 square millimeters , Even better, if the

Flow area at any point is greater than 8 square millimeters, preferably at no point is greater than 5 square millimeters, and still more preferably at no point greater than 3 square millimeters.

At the same time the flow area between the Liquoreintritt and the valve gap between the ball and ball seat or between the valve gap and the CSF leak at no point less than the flow in the Liquoreintritt should be. The valve gap between the ball and ball seat can reduce contrast to zero if no excess cerebrospinal fluid accumulates. With the design of the flow cross section of the invention, the flow rate of the cerebrospinal fluid is to be increased in the valve.

Conveniently for the desired design of the flow cross section can be a pivotal part scheibenariges / rotor when the Liquorleitung along the peripheral surface of the swing member / rotor runs. It can in the

Peripheral surface of the pivoting part / rotor and / or channel-forming in the corresponding valve housing wall grooves wells be provided. The gap between the swivel part / rotor and valve casing wall may in

are conventionally sealed. Preferably, the gap is so narrow that the cerebrospinal fluid can not leak to the gap.

The drawing shows an embodiment of the invention is shown. Fig. 1 and 2 show similar sections through an inventive, adjustable valve. In this case, the valve is locked in Fig. 1, locked and unlocked in Fig. 2 for a valve adjustment.

The valve is located in a drain line for liquor. The inlet side of the valve is designated 10, the outlet side with one first

To the valve includes a housing part with a diameter of 17mm, which is made up of different parts together. With 14 a housing ring is denoted by 15 is a base which the outer shell on one side

closes. All housing parts are made of titanium (titanium alloys) and are welded together. In other embodiments, all housing parts are pressed together, so that the housing is sealed.

The floor 15 of the housing opposite side of the housing is closed by a bivalve lid design. The inner shell 5 is this side of the housing with the necessary stability and has further explained below functions. The outer shell of the lid structure forms a deformable by hand diaphragm / spring blade 2. The outer

Shell / membrane / spring leaf 2 has a corrugated shape and is suddenly bulge under external pressure, after reaching a labile central state against the inner shell / abutment. 5 The inner shell / abutment 5 is adapted to the bulge, which outer the

Shell / membrane / spring leaf 2 occupies. To adapt a stepped recess to the valve center is provided towards. The inner shell 5 forms an abutment for the outer shell / membrane / spring blade 2. As abutment limits the inner shell 5, the movement of the outer

Shell / membrane / spring leaf 2 when a treating physician not with a Adjusting device shown outside pushes the head of the patient against the outer shell / membrane / spring leaf. 2

Entry side, a valve ball 12 is provided in the housing, which is located in a valve seat. 13 The closing pressure of the valve ball is determined depending on the position of the valve by the weight thereof and by bearing against the ball 12 spring, or only by the spring. Of the spring is shown only one end 19 in FIGS. 1 and 2. It is a leaf spring, the end of which is 19 out of FIG. 3 in an arc to a pivoting bracket 21 for the spring. The bow is adapted to the radius of curvature of the housing ring. The other end of the spring is designated 20 and extends from the bracket 21 to a cam track 22 of the housing

pivotally disposed pivoting part / rotor 17. When the

Swiveling part / rotor of FIG. 2 is lifted 17 of the inner shell / abutments 5, the pivoting part / rotor can 17mit the mentioned

Adjusting device are pivoted. Characterized undergoes the spring end 20, a bend or a torque which transmits a result of the pivoting bracket 21 on the other spring end 19 and leads to a change in the closing pressure on the valve ball 12 f.

The swiveling part / rotor 17 is pressed into the locked position of the valve of FIG. 1 against the inner shell / abutments 5. It obtains

Shell / abutment 5 with its surface 3 frictional engagement with the surface 4 of the adjustment / rotor 17th

The locking pressure is generated by a helical spring 1, which is supported at one end on the bottom 15 and at the other end against a collar 23 of an axis. 9 The shaft 9 has one end axially displaceably and rotatably guided in a guide 16 of the valve tray 15th The other end is the Axis 9 slidably and rotatably guided in a bearing bore of the inner shell / abutment. 5

On the axis 9 of the pivot is seated part / rotor 17, the axis 9 in the pivot part / rotor 17 is slidable in the axial direction. In the

Operating position "locking" of FIG. 1, the rotor 17 through the

Frictional engagement with the housing is prevented from rotating. This serves to secure the respective valve position.

In the locking position the shaft 9 faces the inner

Shell / abutment 5 before.

To release the locking the outer shell / membrane / spring leaf 2 is pushed inward until the shell / membrane / spring leaf 2 and the axis have taken 9 to the position shown in Fig. 2. In the position of the swiveling part / rotor 17 has lifted from the inner shell / abutment. 5

On the way from the position of FIG. 1 to the position according to FIG. 2, the outer shell / membrane / spring leaf 2 buckles abruptly against the inner

Shell abutment 5 from. This leads to an acoustic signal; in the

Exemplary to cracking. Moreover, the movement is felt. The cracking and the sensible resilience indicates the attending physician that the lock has been canceled.

When unlocking sets of pressed to the axle 9 ring 8 ensures that no excessive axial displacement of the axis takes place. 9 Also, move the axis 9 no further than to the inner shell / abutments 5, the outer shell / membrane / spring leaf. 2 There closes the upper end of the shaft 9 from the inner shell / abutment.

After unlocking the physician can rotate the swivel part / rotor 17 on the axis 9 with the above-mentioned adjustment device until a desired Pivoting position and thus a desired new closing pressure of the valve has been reached. Then the doctor relieves the outer

Shell / membrane / spring leaf 2. The print is taken from the membrane 2, so that the membrane can regress into the shape shown in FIG. 1 again. At the same time the axis 9 is brought under the pressure of the spring 1 again into the locking position and the necessary for locking

generates frictional engagement. The regression of the outer

Shell / membrane / leaf spring leads to a further popping noise, which is understood by the attending physician as a latch signal.

To generate the Entriegelungsdruckes the attending physician presses with the known, outside the patient's body disposed adjusting device not shown in the middle against the diaphragm 2. Such adjustment devices are shown and described in DE 10200803094.2.

The adjustment device is provided with magnets that interact with magnets 18 together, which are embedded in the pivot part / rotor 17th

After unlocking the adjusting device is rotated by the treating physician.

The rotation of the adjustment device is transmitted via the magnets on the Schenk part / rotor 17. In the exemplary embodiment, four magnets 18 in the swiveling part / rotor 17 arranged.

In the embodiment, the pivoting movement of the Schenk part / rotor is limited 17durch attacks. 6 The stops are 6 pins. In other

can be used as stops embodiments, instead of the pins, any other components.

In the embodiment of the pivoting part / rotor 17, moreover, is with

provided marks, which allow doctors to apply the relevant catching swiveling part / rotor position at X. In the markings is bores 7th

Finally, the housing still marks 24 mounted that the

X allow to check whether the valve has been properly implanted.

Fig. 5 and 6 show another hydrocephalus having cavity

Valve cover. In all other components of the valve is true in FIG. 5 and 6 correspond to the valve according to Fig. 1 to 4.

From the bivalve valve cover corresponds to the inner shell / abutment 30 of the inner shell / abutment 5 according to FIG. 1 to 4. A difference arises in the outer shell / membrane / spring sheet 31.

In the outer shell / membrane / spring leaf 3 a Beulstruktur list provided, which is characterized in the initial position by Fig.5 by a stepped bulge. In each stage, are flat and parallel to the bottom of

Valve housing extending bulging surfaces provided. Between the various stages inclined extending transitional surfaces are provided. The bumps can be shown more easily in the starting material

incorporated as the wave structure of FIG. 1 to 4.

Fig. 7 shows a pressing device for generating a waveform in a shell for a two-shell housing cover made of a titanium alloy. There is the shell in the example of a circular film 41 having a thickness of 0.15 mm and a ring 42. The foil 41 is connected to the ring 42 in

Exemplary integrally manufactured as a turned part on a lathe. In other exemplary embodiments, the film 41 and the ring 42 are as separate parts manufactures and been welded together. By combining a cup-shaped shell of a bivalve housing cover with a flat surface is formed. The diameter of the film is 14.6mm. After Bulging the dish connected as an outer shell with a second shell as the inner bowl to cover. The lid is for a

Hydrocephalus diagnosed with a diameter of 17mm.

In the illustrated starting form the outer shell is provided before the connection to the inner shell with an Beulstruktur. For this, the shell is in a press with a die 43 and a male part 44. The male and female molds have protrusions 45 and depressions 46. In each case a bulge is 45 against a recess 46. In addition, a central bulge 47 is provided, the central one depression 48 opposite. The Fig. 7 includes a sectional view, so that two protrusions 45 with the same distance to the center of the shell part of a ring on the die and on the male part.

Accordingly includes two wells with the same

Distance from the center of the dish to an annular recess.

In a first working step, the die and the punch are moved against each other, so that the protrusions 45 press against the film 41 and caused waves of 0.5mm height.

The shape of the forming waves depends on the curvature of the bulges 45 at the contact surface with the foil 41st For large curves, for example sinusoidally extending waves can be generated. For small (sharp) rounding approximately zigzag extending waves may occur.

After a relief of the film by moving back of the female and male left in the embodiment waves with a height of about 0.25 mm. Thereafter, the film is 41 become much more flexible. Under a load of 1 kg bulges the formed film 41 to 0.2 mm, while a non-deformed, flat sheet 41 bulges only 0.1mm.

In a second working step, the shell is bulged by a further 1mm. In the unloaded state is then obtained a bulge of the film 41 of 0.3 mm.

The resulting shell (from ring 42 and film 41) can be pressed with a centrally applied force of 6 to 7N to 0,6mm. This produces a clicking sound. The resulting shell formed returns after a depression automatically into the original shape when the tray is released again. As applied to bivalve Ventildeckelkonstuktionen according to FIG. 1 to 6, an automatic return of the outer shell by a dent to its original shape is not absolutely necessary, because to be carried out at a dent of äußerenen bowl against a spring force from after relief of the outer shell pressure adjusting device of the

compressed spring resetting / reshaping of the outer shell initiated in the initial form. However, the automatic resetting forms an advantageous safety for the provision / reshaping of the outer shell.

In embodiments of the outer shells of the valve cover with a different diameter found in smaller diameters thinner films application, with larger diameters thicker films. The film thickness is changed, for example, in increments of a few hundredths of a millimeter, to come under the same circumstances, comparable results.