Surgical Outcome of Idiopathic Normal Pressure Hydrocephalus according to the Shunt Devices.
- Author:
Myoung Hoon KIM
1
;
Do Hyun NAM
;
Duk Ryul NA
;
Jung Il LEE
;
Jong Soo KIM
;
Seung Chyul HONG
;
Hyung Jin SHIN
;
Kwan PARK
;
Whan EOH
;
Jong Hyun KIM
Author Information
1. Department of Neurosurgery, Samsung Medical Center, Sungkunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Normal pressure hydrocephalus;
Ventriculoperitoneal shunt;
Siphon-control device
- MeSH:
Aged;
Brain Neoplasms;
Cerebral Infarction;
Craniocerebral Trauma;
Follow-Up Studies;
Hematoma, Subdural;
Humans;
Hydrocephalus, Normal Pressure*;
Intracranial Hemorrhages;
Retrospective Studies;
Ventriculoperitoneal Shunt
- From:Journal of Korean Neurosurgical Society
2002;31(1):27-32
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To determine the effect of shunt devices on the surgical outcome in the idiopathic normal pressure hydrocephalus(NPH), the authors present a retrospective analysis of 39 elderly patients who underwent shunt operations between November 1994 and May 2000, retrospectively. METHODS: The patients enrolled in this study did not have the history of intracranial hemorrhage, head injury, infection, cerebral infarction and brain tumor. The mean age was 69.9(range:52-89) years. Thirteen patients who received operations with simple pressure-control shunt valves(Group I), 22 patients with siphon-control shunt valves(Group II), and four patients with flow-regulating shunt valves (Group III). Final outcome with the clinical improvement and shunt associated complications were evaluated at the last follow-up and the mean follow-up period was 14.7 months. RESULTS: Signs or symptoms of shunt dysfunction were found in eight of 39 patients(20.5%) in the subsequent course. In group I, five out of 13 patients had suffered from symptomatic subdural hematomas and one from overdrainage symptoms(46.2%);in group II, two out of 22 from underdrainage(9%);in group III, one out of four from symptomatic subdural hematomas(25%). Five patients required operative shunt revisions and five underwent burr-hole trephinations for subdural hematomas. Clinical improvements were observed in 10(79.6%), 19(86.4%), and 3(75%) patients in group I, II, and III respectively. Surgical outcomes were better for patients with siphon-control shunt valves than there with the other shunt valves in terms of shunt associated complications and functional improvements(p=0.05). CONCLUSION: The shunt operation with siphon-control shunt valves might be good for the elderly patients with idiopathic NPH.
