Long-term efficacy of shunt therapy in idiopathic normal pressure hydrocephalus

Abstract BACKGROUND Idiopathic normal pressure hydrocephalus (iNPH) is one of very few treatable types of dementia and shunt therapy has been shown to be effective in improving symptoms. However, the long-term results of the cerebral spinal fluid (CSF) diversion are almost variable. The authors conducted a retrospective study investigating the long-term results of iNPH patients treated with ventriculoperitoneal shunt (VPS) by using programmable valves. METHODS The symptoms before treatment were recorded. Post-VPS clinical symptoms and outcome were assessed based on changes in gait, urinary incontinence, and cognitive dysfunction in a yearly follow-up spanning at least 10 years. RESULTS Among a total of 50 patients treated, 5 had died at the time of the authors’ evaluation. The median age was 71 years, and the mean follow-up of the surviving patients was 120.2 ± 2.3. Overall, there was a significant and persistent improvement among all symptoms compared to the baseline (p CONCLUSIONS Surgical treatment for iNPH by VPS is still a safe modality which improves symptoms in most of the patients, even in the long term. Strict follow-ups are necessary to early diagnose shunt malfunction or need for valve adjustment.