Journal of Korean Society of Geriatric Neurosurgery 2014;10(2):103-109.
Published online December 30, 2014.
The Treatment Result of Normal Pressure Hydrocephalus in the Elderly Patients with Dementia : An 8-Year Review of 70 Patients
Hee-Kwon Park , Joon Cho , Sang Woo Song
Department of Neurosurgery, Konkuk University College of Medicine, Seoul, Korea
치매 증상을 가지는 노인 정상 뇌압수두증 환자에 대한 수술 치료 결과 : 70명의 환자에 대한 8년간의 평가
박희권·조 준·송상우
건국대학교 의과대학 신경외과학교실
Abstract
Objective
To review our experience of shunt surgery for normal pressure hydrocephalus (NPH) patients 65 years or over during November 2005 and December 2013.
Methods
The review includes all hydrocephalus patients aged 65 or above during November 2005 and December 2013. All 70 patients had undergone shunt surgery for NPH. 15 patients had idiopathic NPH(iNPH) whereas 55 had secondary NPH (sNPH). We analyzed the results of modified Rankin scale (mRS) and Glasgow Coma Scale (GCS) before and 6 months after the surgery. We also evaluated the opening pressure during lumbar puncture, method of surgery, complication, and symptom improvement in each patient.
Results
In our study, the average GCS and mRS showed improvement after the surgery. Improvement in mRS held a statistical significance (p=0.004) but not in the case of GCS (p=0.061). The improvement in mRS proved to be significant in both the iNPH (p=0.033) and the sNPH groups (p=0.010). The symptom improvement was observed in 53 patients (75.7%) out of 70 in total. For iNPH, the symptom improvement was observed in 12 patients (80%) compared to 41 patients (74.5%) in the sNPH patients. Major complications such as acute and chronic subdural hematoma (SDH), infection, and shunt catheter occlusion were noted in 10 patients. One person had expired due to the massive initial acute SDH.
Conclusion
Neurosurgical outcome for NPH in elderly patients was satisfactory in this study. Therefore, it can be concluded that neurosurgical procedures can be recommended for senile NPH patients.
Key Words: ShuntㆍDementiaㆍElderly patient


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