Predictors of favorable response to implanted of ventriculoperitoneal shunt in patients with idiopathic normal pressure hydrocephalus

  • Mario Emiliano Ricciardi Neurology department, Fleni , Buenos Aires, Argentina
  • Ismael Calandri Cognitive Neurology, Neuropsychology and Neuropsychiatry department, Fleni, Buenos Aires, Argentina
  • Lucas Alessandro Neurology department, Fleni, Buenos Aires, Argentina
  • Mauricio Farez Center for Research on Neuroimmunological Diseases (CIEN), Fleni, Buenos Aires,
  • Juan Villalonga Neurosurgery department, Fleni, Buenos Aires, Argentina.
  • Martin Fausti Neurosurgery department, Fleni, Buenos Aires, Argentina.
  • Frida Herrmann Diagnostic imaging department, Fleni, Buenos Aires, Argentina.
  • Ricardo Allegri Cognitive Neurology, Neuropsychology and Neuropsychiatry department, Fleni, Buenos Aires, Argentina

Abstract

Introduction: The indication of a ventriculoperitoneal shunt (VPS) is discussed in patients with idiopathic normal pressure hydrocephalus (iNPH), due to the heterogeneity of the response to treatment and the risks involved in neurosurgery. Objective: To search for clinical factors and complementary studies in order to determine predictors of a favorable response to the VPS placement in patients with iNPH. Methodology: A retrospective study of patients with probable iNPH (according to international guidelines) treated with VPS assisted in a neurological clinic from January 2014 to January 2017 was conducted. A univariate statistical
analysis of the variables considered as possible prognostic factors was performed. Results: 58 patients were included. Women presented 3.68 times more chances of improvement after the VPS (p=0.019). Good response to the gait test was associated with better response to the VPS (p=0.024). Conclusions: Female sex and good response to the gait test could be considered as predictors of a favorable response to the VPS placement in patients with iNPH. A prospective study is necessary to achieve a homogeneous diagnostic evaluation and a more extensive longitudinal follow-up to evaluate the clinical evolution in this group of patients.

Keywords: Idiopathic normal pressure hydrocephalus, Ventriculoperitoneal shunt, Cognitive impairment, Gait disorder, Neurosurgery.

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Published
2020-12-09
How to Cite
Ricciardi, M., Calandri, I., Alessandro, L., Farez, M., Villalonga, J., Fausti, M., Herrmann, F., & Allegri, R. (2020). Predictors of favorable response to implanted of ventriculoperitoneal shunt in patients with idiopathic normal pressure hydrocephalus. Journal of Applied Cognitive Neuroscience, 1(1), 81-86. Retrieved from https://revistascientificas.cuc.edu.co/JACN/article/view/3337