OBJECTIVEThe management of secondary normal pressure hydrocephalus (sNPH) is controversial. Many factors may affect the surgery effect. The purpose of this study was to identify the possible factors influencing prognosis and provide theoretical basis for clinical treatment of sNPH.

METHODSA retrospective study was carried out to investigate the results of 31 patients with sNPH who underwent ventriculoperitoneal shunt surgery from January 2007 to December 2011. We processed the potential influencing factors by univariate analysis and the result further by multivariate logistic regression analysis.

RESULTSFactors including age, disease duration and Glasgow coma scale (GCS) score before surgery significantly influenced the prognosis of sNPH (P less than 0.05). Further logistic regression analysis showed that all the three factors are independent influencing factors.

CONCLUSIONAge, disease duration and GCS score before surgery have positive predictive value in estimating favorable response to surgical treatment for sNPH.

Adult ; Female ; Humans ; Hydrocephalus, Normal Pressure ; surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Ventriculoperitoneal Shunt

OBJECTIVETo assess zero drift of intraventricular and subdural intracranial pressure (ICP) monitoring systems.

METHODSA prospective study was conducted in patients who received Codman ICP monitoring in the neurosurgical department from January 2010 to December 2011. According to the location of sensors, the patients were categorized into two groups: intraventricular group and subdural group. Zero drift between the two groups and its association with the duration of ICP monitor were analyzed.

RESULTSTotally, 22 patients undergoing intraventricular ICP monitoring and 27 receiving subdural ICP monitoring were enrolled. There was no significant difference in duration of ICP monitoring, zero drift value and its absolute value between intraventricular and subdural groups (5.38 d+/-2.58 d vs 4.58 d+/-2.24 d, 0.77 mm Hg+/-2.18 mm Hg vs 1.03 mm Hg+/-2.06 mm Hg, 1.68 mm Hg+/-1.55 mm Hg vs 1.70 mm Hg+/-1.53 mm Hg, respectively; all P larger than 0.05). Absolute value of zero drift in both groups significantly rose with the increased duration of ICP monitoring (P less than 0.05) while zero drift value did not. Moreover, daily absolute value in the intraventricular group was significantly smaller than that in the subdural group (0.27 mm Hg+/-0.32 mm Hg vs 0.29 mm Hg+/-0.18 mm Hg, P less than 0.05).

CONCLUSIONThis study demonstrates that absolute value of zero drift significantly correlates with duration of both intraventricular and subdural ICP monitoring. Due to the smaller daily absolute value, ICP values recorded from intraventricular system may be more reliable than those from subdural system.

Aged ; Cerebral Ventricles ; Female ; Humans ; Intracranial Pressure ; Male ; Middle Aged ; Monitoring, Physiologic ; Prospective Studies ; Subdural Space

Objective To compare the operative effectivity and incidence of postoperative complication between conventional uvulopalatopharyngoplasty (UPPP) and modified coblation assisted UPPP (M-CAUP) in treating patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).And to explore the more effective,safer and minimally invasive operative method in surgical therapy of OSAHS.Methods It was a controlled trial.A retrospective analysis was made on surgical complications of conventional UPPP and of M-CAUP performed on OSAHS patients from 1995 to 2010.There were 451 patients in UPPP group and 323 patients in M-CAUP group.x2 test and Fisher's Exact test were used in statistical analysis.Results The incidence of serious surgical complications was higher in conventional UPPP group (3.77％,17/451) than that in M-CAUP group (0.62％,2/323),x2 =7.800,P ＜ 0.01,while the incidence of short-term complications was higher in M-CAUP group (90.40％,292/323 ) than that in conventional UPPP group (60.98％,275/451),x2 =83.186,P ＜ 0.01.The difference of long-term complications was not statistically significant between M-CAUP group and conventional UPPP group (P =0.1331,Fisher Exact test).There was no significant difference in incidence of asphyxia between M-CAUP group and conventional UPPP group (P ＜ 0.01,Fisher Exact test).However,the incidence of post-operative primary hemorrhage was obviously lower in M-CAUP group than that in conventional UPPP group ( 3.99％,18/451 ),x2 =12.133,P ＜ 0.01.While the incidence of delayed hemorrhage,temporal velopharyngeal insufficiency,and foreign body sensation at pharynx were higher in M-CAUP group (8.05％, 12.69％, 68.42％,respectively) than that in conventional UPPP group (3.77％,3.33％,51.00％,respectively) P ＜0.01,respectively.There was no significant difference in incidence of permanent velopharyngeal insufficiency,stenosis of nasopharynx and nasopharyngeal atresia,alteration of taste,throat itch and coughing.Conclusion Compared to the conventional UPPP,M-CAUP was more effective and safer in treating OSAHS with less severe complications during and after the operation.