| Clinical Analysis of Prognostic Factors and Complications for Geriatric Hydrocephalus Patients Who Underwent Shunt Surgery or Revision |
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Jee Wook Ryu , Min Ki Kim , Sung Ho Lee , Seok Keun Choi , Bong Jin Park , Young Jin Lim |
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Department of Neurosurgery, Kyung-Hee University College of Medicine, Seoul, Korea |
| 단락술과 재수술을 시행한 수두증 노인 환자의 예후와 합병증 |
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유지욱ㆍ김민기ㆍ이성호ㆍ최석근ㆍ박봉진ㆍ임영진 |
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희대학교 의과대학 신경외과학교실 |
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| Abstract |
Objective
Ventriculo-peritoneal shunt remains the most widely accepted neurosurgical procedure for the management of hydrocephalus. However,
shunt failures are not uncommon and may require multiple surgical procedures during a patient’s lifetime. We performed a retrospective
study to analyze the clinical features and outcomes of hydrocephalus geriatric patients who underwent shunt surgery.
Methods
Total 53 geriatric patients underwent shunt surgery or revision between January 2008 and December 2012. Among these patients.
We divided patients into two groups including those with good response to shunt surgery (Group I) and those with poor response (Group II) by
GOS scale. Data was analyzed to clinical diagnosis, type of hydrocephalus, cause of revision shunt operation, computed tomography scans,
radionuclide cisternography and complications.
Results
A total 53 patients with the patients with the median age of 71 years were included. 39 patients were included in group I and 14
patients in group II. There are no significant differences in age, diagnosis, interval from shunt surgery. The most common etiologies included
post-hemorrhagic (43.4%), tumors and cysts (22.6%), post-traumatic (18.8%) and NPH (9.4%). 6 patients of group II required shunt revisions
within 6months. The major causes of shunt revision include obstruction (21.4%), old shunt malfunction (21.4%) and shunt infection (14.3%).
Conclusion
The results of our retrospective study show that ventriculo-peritoneal shunt is beneficial in the management of geriatric patients
with hydrocephalus. For better results, it is need to confirm initial GCS score and radiographic images. We should also consider appropriate
valve pressure adjustment and a shunt infection to prevent repeated revisions. |
| Key Words:
GeriatricㆍHydrocephalusㆍShunt surgeryㆍRevision
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