gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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The Italian prospective multicenter web-based idiopathic Normal Pressure Hydrocephalus (NPH) study. Analysis of shunt-related complications

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  • corresponding author Domenico d'Avella - Department of Neurosciences, University of Padova Medical School, Padova, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.10.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc105.shtml

Published: May 30, 2008

© 2008 d'Avella.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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On behalf of the Italian NPH group of the SINch (Angileri F, Anile C, Benericetti E, Ferroli P, Gangemi M, Germanò A, Godano U, Marton E, Mascari C, Princi P, Scerrati M)

Objective: A multicenter prospective controlled study was performed for the diagnosis, treatment, and analysis of long-term outcomes in NPH. Aim of this study is to describe the rate of complications, morbidity, and mortality associated with shunts at the time of the operation and after the surgical procedure.

Methods: A total of 106 patients were enrolled. Patients were implanted a Codman Hakim programmable shunt valve. Enrolment was based on the criteria of the Italian Study Group of NPH. Study end points were: 1) direct acute and/or long-term surgical-related complications, and 2) shunt failure (surgical intervention for any component of the shunt).

Results: Median follow-up for the study was 18.2 months. Mortality rate was 2.82%, due to pulmonary embolia. Total complication rate was 12.26%, requiring a +7.54% of additional surgeries. Total intra-operative complications were 1.88%, and late shunt malfunctions occurred in 6.6%. We recorded 2.82% of subdural fluid collections, being surgically evacuated in one case and treated with valve pressure readjustment in another. Infection rate was 1.88%, limited to the abdominal incision, which was medically treated. Valve opening pressure re-adjustments were necessary in 38.67%.

Conclusions: The increased knowledge on the topic, the modern standard of care of patients, the application of rigid inclusion criteria for selecting appropriate shunt-candidates, and the availability of programmable valves make shunt surgery in NPH patient a safer procedure, as compared with previous literature data.