Cerebrospinal fluid dynamics and long-term survival of the Strata valve in idiopathic normal pressure hydrocephalus

Acta Neurologica Scandinavica
B LundkvistJ Malm

Abstract

Cerebrospinal fluid (CSF) dynamics and long-term shunt survival of the Strata CSF shunt were evaluated in patients with idiopathic normal pressure hydrocephalus (INPH). Seventy-two patients with INPH received a Strata valve. A CSF infusion test, neuroimaging and video recording of gait were performed at baseline and at 6 months (n = 68) after surgery. Long-term shunt survivals were obtained from patient records. The shunt survival at 1 year was 94% and at 3 years 92.5%. Forty-nine patients (72%) had an improved gait. Two patients were improved despite non-functioning shunts, indicating a possible placebo response. Nineteen patients were not improved at the 6-month follow-up. The shunt tests revealed a functioning shunt in 12; thus, unnecessary shunt revisions could be avoided. Seventeen patients showed a siphoning effect. Shunt revisions were made in six patients. Eight hygromas/subdural hematomas were found. The long-term survival of the Strata valves was good, and a concern of complications is not a reason to exclude elderly with INPH from shunt surgery. Studies are needed to evaluate pros and cons of the anti-siphon device. Using a CSF shunt test, unnecessary shunt revisions may be avoided.

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Citations

Mar 10, 2011·Fluids and Barriers of the CNS·Kennet AnderssonAnders Eklund
May 31, 2012·Fluids and Barriers of the CNS·Anders EklundJan Malm
Feb 15, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Sara QvarlanderAnders Eklund
Mar 13, 2014·Biomedical Microdevices·Staffan B JohanssonNiclas Roxhed
Jul 9, 2013·Clinical Neurology and Neurosurgery·Florian Baptist FreimannChristian Sprung
Apr 17, 2013·Arquivos de neuro-psiquiatria·Matheus Fernandes de OliveiraFernando Campos Gomes Pinto
Aug 8, 2015·Revista da Associação Médica Brasileira·Matheus Fernandes de OliveiraFernando Campos Gomes Pinto
May 11, 2012·Acta Neurologica Scandinavica·P KlingeUNKNOWN European iNPH Multicentre Study Group
Jan 3, 2013·Acta Neurologica Scandinavica·K AnderssonA Eklund
Nov 3, 2020·Acta neurologica Belgica·Matheus Fernandes de OliveiraF C G Pinto

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