A double-blind randomized trial on the clinical effect of different shunt valve settings in idiopathic normal pressure hydrocephalus

Journal of Neurosurgery
Dan FarahmandC Wikkelsö

Abstract

The study aim was to examine the effect of gradually reducing the opening pressure on symptoms and signs in the shunt treatment of idiopathic normal pressure hydrocephalus (iNPH). In this prospective double-blinded, randomized, controlled, double-center study on patients with iNPH, a ventriculoperitoneal shunt with an adjustable Codman Medos Valve was implanted in 68 patients randomized into 2 groups. In 1 group (the 20-4 group) the valve setting was initially set to 20 cm H2O and gradually reduced to 4 cm H2O over the course of the 6-month study period. In the other group (the 12 group), the valve was kept at a medium level of 12 cm H2O during the whole study period. All patients were clinically evaluated using 4 tests preoperatively as well as postoperatively at 1, 2, 3, 4, and 6 months. The test scores between the 2 groups (20-4 and 12) were compared for each clinical evaluation. Fifty-five patients (81%) were able to complete the study. There were no significant differences between the 2 groups (20-4 and 12) preoperatively or at any time postoperatively. Both groups exhibited significant clinical improvement after shunt insertion at all valve settings compared with the preoperative score, with the greatest improvement obser...Continue Reading

References

Feb 9, 2006·Acta Neurochirurgica. Supplement·A MarmarouUNKNOWN International NPH Consultant Group
Sep 7, 2006·British Journal of Neurosurgery·M TisellC Wikkelsö
Feb 10, 2007·Neurosurgery·Babar KahlonStig Rehncrona
Mar 19, 2009·Journal of Neurology, Neurosurgery, and Psychiatry·D FarahmandM Tisell
May 11, 2012·Acta Neurologica Scandinavica·P KlingeUNKNOWN European iNPH Multicentre Study Group
May 17, 2012·Acta Neurologica Scandinavica·P HellströmC Wikkelsø
Aug 27, 2013·Acta neurochirurgica·Ahmed K TomaLaurence D Watkins
Oct 1, 2013·Journal of Neurosurgery·Johan VirhammarElna-Marie Larsson
Jun 26, 2014·Journal of Neurology, Neurosurgery, and Psychiatry·Dan FarahmandMagnus Tisell

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Citations

Jun 27, 2017·International Journal of Surgery·Min LiXiaoping Yin
Sep 23, 2020·Movement Disorders : Official Journal of the Movement Disorder Society·Alfonso FasanoJoachim K Krauss
May 12, 2018·Journal of Neurosurgery·Nitin AgarwalRobert M Friedlander
Nov 13, 2020·Expert Review of Medical Devices·Paweł GutowskiUlrich-Wilhelm Thomale
Jan 19, 2021·Neurologia Medico-chirurgica·Madoka NakajimaUNKNOWN research committee of idiopathic normal pressure hydrocephalus

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