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Gravitational valve with extra large flow path

The MIETHKE DUALSWITCH is a valve for the different types of adult hydrocephalus. 
A high protein content or tumour cells in the CSF can lead to a blockage of a valve. These aspects were given special consideration in the development of the MIETHKE DUALSWITCH VALVE. The special design of the valve provides the CSF with a very large surface area, so that reliable function is guaranteed as far as possible even in contaminated fluid. [1,3]

To also reduce overdrainage complications, the valve is also equipped with gravitational technology. Clinical studies show good efficacy here. [1,2 3,4,5,6,7,8,9]

The MIETHKE DUALSWITCH VALVE is made of titanium, a material that allows excellent precision, reliability and biocompatibility.


  • Automatic switch of opening pressure
  • Large surface area to CSF
  • Reliable even with contaminated fluid


The MIETHKE DUALSWITCH VALVE is available as a single valve or as a shunt system with different components.


  • Treatment of Hydrocephalus

[1] Hertel F, Züchner M, Decker C, Schill S, Bosniak I, Bettag M. The Miethke dual switch valve: experience in 169 adult patients with different kinds of hydrocephalus: an open field study. Minim Invasive Neurosurg. 2008 Jun;51(3):147-53. doi: 10.1055/s-2008-1065337. PMID: 18521785.

[2] Kiefer M, Eymann R. Gravitational shunt complications after a five-year follow-up. Acta Neurochir Suppl. 2010;106:107-12. doi: 10.1007/978-3-211-98811-4_18. PMID: 19812930.

[3] Sprung C, Miethke C, Schlosser HG, Brock M. The enigma of underdrainage in shunting with hydrostatic valves and possible solutions. Acta Neurochir Suppl. 2005;95:229-35. doi: 10.1007/3-211-32318-x_47. PMID: 16463855.

[4] Meier U, Kiefer M, Sprung C. Evaluation of the Miethke dual- switch valve in patients with normal pressure hydrocephalus. Surg Neurol. 2004 Feb;61(2):119-27; discussion 127-8. doi: 10.1016/j.surneu.2003.05.003. PMID: 14751612.

[5] Sprung C, Miethke C, Shakeri K, Lanksch WR. The importance of the dual-switch valve for the treatment of adult normotensive or hypertensive hydrocephalus. Eur J Pediatr Surg. 1997 Dec;7 Suppl 1:38-40. doi: 10.1055/s-2008-1071208. Erratum in: Eur J Pediatr Surg 1998 Feb;8(1):64. Shaken, K [corrected to Shakeri, K]. PMID: 9497116.

[6] Trost HA, Sprung C, Lanksch W, Stolke D, Miethke C. Dual-switch valve: clinical performance of a new hydrocephalus valve. Acta Neurochir Suppl. 1998;71:360-3. doi: 10.1007/978-3-7091-6475-4_104. PMID: 9779230.

[7] Zeilinger FS, Reyer T, Meier U, Kintzel D. Clinical experiences with the dual-switch valve in patients with normal pressure hydrocephalus. Acta Neurochir Suppl. 2000;76:559-62. doi: 10.1007/978-3-7091-6346-7_116. PMID: 11450090.

[8] Poca MA, Gándara DF, Rosas K, Alcina A, López-Bermeo D, Sahuquillo J. Considerations in the Use of Gravitational Valves in the Management of Hydrocephalus. Some Lessons Learned with the Dual-Switch Valve. J Clin Med. 2021 Jan 12;10(2):246. doi: 10.3390/jcm10020246. PMID: 33445418; PMCID: PMC7830811.

[9] Tsunoda A, Maruki C. Clinical experience with a dual switch valve (Miethke) for the management of adult hydrocephalus. Neurol Med Chir (Tokyo). 2007 Sep;47(9):403-8; discussion 408. doi: 10.2176/nmc.47.403. PMID: 17895613.