| Clinical Outcomes of Ventriculo-Peritoneal Shunt in Idiopathic Normal Pressure Hydrocephalus |
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Dong-Woo Yu , Jong-Hoon Kim , Min-Su Kim , Young-Jin Jung , Seong-Ho Kim |
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Departments of Neurosurgery, Yeungnam University College of Medicine, Daegu, Korea |
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| Abstract |
Objective
Normal pressure hydrocephalus in patients without known precipitants is termed primary or idiopathic NPH (iNPH). This study compares the clinical outcomes based on symptoms, psychometric tests, and radiologic findings among iNPH patients before and after undergoing ventriculo-peritoneal shunts (VPS).
Methods
A total of 45 patients with iNPH were selected to undergo VPS between 2004 and 2009. Improvements in their symptoms were determined by measuring and comparing pre and postoperative Evans ratios, clinical symptoms, and signs. Based on CT findings (increased ventricle size, compact brain parenchyma toward the vertex, and widening sylvian fissures), we looked for the presence of these characteristics in all of the patients and evaluated symptom improvement with the Pearson’s chi-square and Fisher’s exact tests.
Results
There was a significant difference between preoperative symptom duration and an improvement in symptoms. The preoperative symptom duration of the one year or less group revealed a statistical benefit in our study (p=0.03). Of the 29 patients who showed compact brain parenchyma toward the vertex and widening sylvian fissures, 24 (82.8%) showed improvements in their symptoms. The improvement rate of the group with compatible CT findings was higher than that of the group without the findings; there was a statistical significance (p=0.037).
Conclusion
Therefore, prompt diagnosis and surgical treatment would be effective and beneficial in order to improve the symptoms of iNPH patients and offer them a better quality of life. |
| Key Words:
HydrocephalusㆍGaitㆍDementiaㆍVentriculo-peritoneal shunt |
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