| ObjectiveNormal pressure hydrocephalus(NPH) is a type of syndrome that is associated with enlarged ventricle in the absence of raised cerebrospinal fluid pressure and is characterized by gait disorder, dementia and urinary incontinence. Shunt surgery is most adopted in the treatment of normal pressure hydrocephalus. In this study, we will compare ventriculoperitoneal shunts with lumboperitoneal shunts in the improvement of symptoms, complications and prognosis.MethodsWe retrospectively reviewed our54patients with LP or VP shunts inserted for the treatment of NPH from January2014to August2014.42of them were underwent VP shunt and the remaining12were underwent LP shunts. After an average follow-up period of8-12months, the improvement of symptoms、complications and score of GOS were recorded. Statistical analysis of the outcome was performed. The results were statistically significant if p<0.05.ResultAmong the54included patients, there were35males and19females. The average age was58.2±12.6years old and average follow-up period was10.87±1.92months. These cases included13(24.1%) patients with Idiopathic normal pressure hydrocephalus,18(33.3%) patients after traumatic brain injury,14(25.9%) patients after subarachnoid hemorrhage,4(7.4%) patients after intracranial tumor and5(9.3%) patients after cerebral hemorrhage. The gender, age, follow-up time and causes of both groups had no significant difference. The improvement rates of symptoms for VP shunts and LP shunts, respectively, were as follows:gait disorder58.3%versus54.5%(p=0.824), dementia57.1%versus60.0%(p=0.872), and urinary incontinence41.4%versus44.4%(p=0.871), with no significant difference. The complications in the group of VP shunts included4(9.5%) cases of blockage of shunt,3(7.1%) cases of infection,1(2.4%) case of intracranial hematoma and2(4.8%) case of seizure. There appeared2(16.7%) cases of blockage of shunt in the LP group, which is higher than the rate of VP grope but with no significant difference (p=0.862). And the scores of GOS of both groups also had no significant difference (p=0.410).ConclusionsBoth ventriculoperitoneal shunts and lumboperitoneal shunts can improve the symptoms of normal pressure hydrocephalus effectively, with no significant difference. The complications in the group of VP shunts included blockage of shunt, infection, intracranial hematoma and seizure. It appeared more rate of blockage in LP group while there was no statistically significant difference. And the scores of GOS were also similar. So, LP shunt can be an alternative to VP shunt in cases of normal pressure hydrocephalus. |
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