gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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

Kranheitsverlauf 3 Jahre nach Shuntoperation bei Patienten mit idiopathischem Normaldruckhydrozephalus

Meeting Abstract

Suche in Medline nach

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

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP141

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0409.shtml

Veröffentlicht: 4. Mai 2005

© 2005 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, resulting in 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 and after the operation and re-evaluated 1 year after surgery. 50 patients were re-evaluated 3 years (interval 1 to 5 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 an only minimal reduction of the ventricular size in the majority of the cases. We found a valve-related rate of overdrainage of 3% wich is clearly lower than results of comparable series in the literature. The valve-related underdrainage was 10%, and the infections rate 3%.

Conclusions

The clinical course of of patients suffering from iNPH is mainly influenced by the stage of disease, the start of 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.