gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Clinical course of disease 3 years after surgery in patients with idiopathic normal pressure hydrocephalus

Der klinische Verlauf von Patienten mit idiopathischem Normaldruckhydrozephalus 3 Jahre nach Shunt-Operation

Meeting Abstract

Suche in Medline nach

  • corresponding author Ullrich Meier - Department of Neurosurgery, Unfallkrankenhaus Berlin-Marzahn, Berlin
  • J. Lemcke - Department of Neurosurgery, Unfallkrankenhaus Berlin-Marzahn, Berlin

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.02.03

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0028.shtml

Veröffentlicht: 23. April 2004

© 2004 Meier et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Especially in patients with idiopathic normal pressure hydrocephalus (iNPH) conventional differential-pressure valves are known to create unphysiological negative intraventricular pressure values (IVP), when the patient moves into the upright position, with the consequence of numerous, sometimes severe complications. The recently presented gravitational devices promise improvement primarily in respect to this disadvantage.

Methods

In a prospective study the Miethke Dual-Switch valve (M-DSV) was implanted in 60 patients with iNPH. The patients were assessed prior to operation, at discharge and re-evaluated 1 year after surgery. Fifty patients were re-evaluated 3 years (interval: 1,5 - 6 years) after operation. The technical principle of the device is presented.

Results

The clinical follow-up showed excellent or good results in 62% of the patients, satisfactory results in 14% and a poor outcome in 24% of the cases. The outcome correlated with the preoperative severity of NPH. Despite the clinical outcome, the CT-scans showed nearly no (or only a minimal) reduction of the ventricular size in the majority of cases. We found a valve-related rate of overdrainage of 3% which is clearly lower than results of comparable series in the literature. The valve-related rate of underdrainage was 10%, and the infections rate 3%.

Conclusions

The clinical course of patients suffering from iNPH is mainly influenced by the stage of the disease, the time of beginning the therapy and the gravitational function of the implanted device. Based on our clinical experiences with the M-DSV we underline the advantages of this valve for the treatment of hydrocephalus especially for patients with iNPH.