Long-term outcomes of adult chronic idiopathic hydrocephalus treated with a ventriculo-peritoneal shunt.

Autor:	Illán-Gala I; Servicio de Neurología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria IdiPAZ, Universidad Autónoma de Madrid, Madrid, España. Electronic address: ignacio.illan@gmail.com., Pérez-Lucas J; Servicio de Neurología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria IdiPAZ, Universidad Autónoma de Madrid, Madrid, España., Martín-Montes A; Servicio de Neurología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria IdiPAZ, Universidad Autónoma de Madrid, Madrid, España., Máñez-Miró J; Servicio de Neurología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria IdiPAZ, Universidad Autónoma de Madrid, Madrid, España., Arpa J; Servicio de Neurología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria IdiPAZ, Universidad Autónoma de Madrid, Madrid, España., Ruiz-Ares G; Servicio de Neurología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria IdiPAZ, Universidad Autónoma de Madrid, Madrid, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Neurologia (Barcelona, Spain) [Neurologia] 2017 May; Vol. 32 (4), pp. 205-212. Date of Electronic Publication: 2015 Dec 31.
DOI:	10.1016/j.nrl.2015.10.002
Abstrakt:	Introduction: Adult chronic idiopathic hydrocephalus (ACIH) is a cause of dementia that can be treated by implanting a ventriculo-peritoneal shunt (VPS). We aim to study clinical and functional outcomes in patients with ACIH corrected with a VPS. Subjects and Methods: Observational cohort study of patients diagnosed with probable ACIH (Japan Neurosurgical Society guidelines) and undergoing shunt placement between 2008 and 2013 in a centre of reference for neurosurgery in Spain. Clinical improvement was classified in 4 categories (resolution, partial improvement, equivocal improvement, and no improvement); functional outcome was assessed on the modified Rankin scale (mRS). Results: The study included 29 patients with a mean age of 73.9 years; 62.1% were male and 65.5% had hypertension. Clinical improvement (complete or partial) was observed in 58% after one year and in 48% by the end of the follow-up period (mean follow-up time was 37.8 months). Older age, presence of hypertension, and surgery-related complications were more prevalent in the group responding poorly to treatment. One patient died, 20.7% experienced severe complications, and 69% were dependent (mRS ≥ 3) by the end of the follow-up period. Age at diagnosis was independently associated with poorer clinical response at one year and a higher degree of dependency by the end of follow-up. Conclusion: Symptomatic benefits offered by VPS were partial and transient; treatment was associated with a high complication rate and poor functional outcomes in the long term, especially in the oldest patients. (Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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