Outcomes of Ventriculoperitoneal Shunt in Patients With Idiopathic Normal-Pressure Hydrocephalus 2 Years After Surgery

Abstract

Objective: To evaluate the outcomes and prognostic factors of ventriculoperitoneal shunts (VP-shunts) in patients with idiopathic normal-pressure hydrocephalus (iNPH) at 6 months and 2 years after surgery.Method: We retrospectively analyzed 68 patients admitted to our institute and diagnosed with probable iNPH from January 2017 to March 2021. All patients underwent VP-shunt surgery with a programmable valve, and their outcomes were assessed via the Krauss index and modified Rankin scale (mRS) at 6 months and 2 years post-surgery. Univariate and multivariate regression analysis was performed to identify the prognostic factors.Results: The mean age of the patients was 71.1 ± 8.4 (mean ± standard deviation) years. On the Krauss improvement index, 6-month follow-up results were available for 68 patients. Of these patients, 91.2% experienced attenuation of their preoperative symptoms, with a mean Krauss index of 0.58 ± 0.27, and 48 patients (70.6%) had a Krauss index ≥0.5. Two-year follow-up results were available for 33 patients; 90.9% of them had sustained improvement, with a Krauss index of 0.54 ± 0.31, and 21 patients (66.3%) had a Krauss index ≥0.5. Thirty-three patients (58%) were living independently after 2 years (mRS 0–2). The outcomes were worse for patients with multiple comorbidities. Neither an increased patient age nor a prolonged history of illness was statistically significant prognostic factors for adverse outcomes of VP-shunt surgery.Conclusion: Surgical treatment was well-tolerated by patients with iNPH who received VP-shunts. Most patients experienced attenuation of their preoperative symptoms. Multiple concurrent comorbidities should be considered as adverse prognostic factors before shunt insertion in patients with iNPH.

Idiopathic Normal Pressure Hydrocephalus and Progressive Supranuclear Palsy: Two Single Entities or Neurodegenerative Overlap Syndrome? A Case Report

“…This is particularly important because for patients with iNPH, treatment with a VP shunt leads to an improvement in the condition or a slowing down of the progression of the disease [11]. Therapy with a VP shunt has a success rate of up to 80% in patients and a relatively low rate of complications [12].…”

Ventriculoperitoneal Shunt Failure 3-year after Shunt Surgery Caused by Migration of Detached Ventricular Catheter into the Cranium: A Case Study of Idiopathic Normal-pressure Hydrocephalus

“…Some controlled studies have shown that age does not predict postoperative improvement in iNPH. 25,41) Kobayashi et al noted that the duration of untreated iNPH, but not age, predicts unfavorable postoperative improvement. 42) Recent studies suggest that shunt therapy for iNPH can NMC Case Report Journal Vol.…”

Abnormal characteristic static and dynamic functional network connectivity in idiopathic normal pressure hydrocephalus

“…The definite diagnosis depends on symptom reversal after CSF tap test (TT) and shunt surgery 2 . The degree of symptom reversal after shunting varies according to the condition of the patient 3–5 . Neither the pathophysiological mechanisms nor the neural networks underlying this phenomenon have been elucidated to date.…”