Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus

Clinical Neurology and Neurosurgery
Ann LiuDaniele Rigamonti

Abstract

Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder that classically presents with a triad of progressive gait impairment, urinary incontinence, and cognitive deterioration. Treatment predominantly involves ventriculoperitoneal (VP) shunting, but one alternative is ventriculoatrial (VA) shunting. This study sought to describe and evaluate the clinical outcomes of patients with iNPH primarily treated with VA shunting. A retrospective review of patients with iNPH who were treated with VA shunting at a single institution, from 2003 to 2013, was performed. 58 patients with iNPH underwent primary VA shunting at a median age of 74 (IQR: 70-80) years. The most common comorbidities included hypertension (n=39, 67%) and diabetes mellitus (n=11, 19%). Median duration of symptoms prior to VA shunting was 24 (IQR: 12-36) months. All patients had gait impairment, 52 (90%) had cognitive decline, and 43 (74%) had urinary incontinence. Forty-three (74%) patients had all three symptoms. At a median last follow-up of 16 (IQR: 7-26) months, median iNPH score improved from 6 to 3 (p<0.0001), mini mental status exam (MMSE) tended to increase from 26 to 29 (p=0.082), timed up-and-go (TUG) improved from 18 to 13s (p<0.0001), an...Continue Reading

References

Apr 1, 1977·Journal of Neurology, Neurosurgery, and Psychiatry·J O GreenbergR Adam
May 1, 1990·Fortschritte der Neurologie-Psychiatrie·W A Dauch, R Zimmermann
Sep 1, 1986·Annals of Neurology·A M ThomsenF Gjerris
Jan 1, 1996·Stroke; a Journal of Cerebral Circulation·J K KraussT Mergner
Jul 11, 2003·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ullrich Meier, Christoph Miethke
Jul 15, 1965·The New England Journal of Medicine·R D ADAMSW H SWEET
Sep 15, 2005·Neurosurgery·Marvin BergsneiderNorman Relkin
Nov 21, 2007·Dementia and Geriatric Cognitive Disorders·Yoshihiko KuboMasatoshi Takeda
Oct 4, 2008·Journal of Neurosurgery. Pediatrics·Norka WilkinsonMadhvi Rajpurkar
Jun 6, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·George RazayJohn Liddell
Jul 6, 2010·Journal of Neurosurgery·Stefan KlugeAndreas Meyer
Jan 18, 2011·Journal of Neurosurgery·Magnus TisellCarsten Wikkelsö
Nov 3, 2012·Neurosurgical Focus·Judith M WongAtul A Gawande
Aug 27, 2013·Acta neurochirurgica·Ahmed K TomaLaurence D Watkins
Dec 3, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Kerstin AndrénPer Hellström
Mar 13, 2014·Journal of Neurosurgery·Robert A McGovernGuy M McKhann

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Citations

Dec 6, 2017·Journal of Neurosciences in Rural Practice·Naresh MullaguriPremkumar Nattanmai
Dec 1, 2017·Neurology. Clinical Practice·Shigeki YamadaEtsuro Mori
Jun 10, 2020·Journal of Neurologic Physical Therapy : JNPT·Shannon FillmoreGabriele Moriello
Jan 23, 2021·Neurosurgical Review·Cezar Octavian MorosanuIoan Stefan Florian
Dec 18, 2020·Acta neurochirurgica·Lorenzo MagrassiPietro Quaretti
Jan 19, 2021·Neurologia Medico-chirurgica·Madoka NakajimaUNKNOWN research committee of idiopathic normal pressure hydrocephalus
May 1, 2021·Journal of Clinical Medicine·Afroditi Despina LalouZofia Czosnyka

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