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Decreases in Ventricular Volume Correlate with Decreases in Ventricular Pressure in Idiopathic Normal Pressure Hydrocephalus Patients Who Experienced Clinical Improvement after Implantation with Adjustable Valve Shunts
| Content Provider | Scilit |
|---|---|
| Author | McConnell, Kathleen A. Zou, Kelly H. Chabrerie, Alexandra V. Bailey, Nancy Olsen Black, Peter McL. |
| Copyright Year | 2004 |
| Description | Journal: Neurosurgery This retrospective study examined whether changes in ventricular volume correspond with changes in adjustable valve pressure settings in a cohort of patients who received shunts to treat idiopathic normal pressure hydrocephalus. We also examined whether these pressure–volume curves and other patient variables would co-occur with a positive clinical response to shunting. We selected 51 patients diagnosed with idiopathic normal pressure hydrocephalus who had undergone implantation of a Codman Hakim programmable valve (Medos S.A., Le Locle, Switzerland). Clinical data were gathered from the patients' records and clinical notes by an investigator blinded to patients' ventricular volumes. Ventricular volume was measured using 3D Slicer, an image analysis and interactive visualization software package developed and maintained at the Surgical Planning Laboratory at Brigham and Women's Hospital. Eighty-six percent of patients with gait disturbance at presentation showed improvement of this symptom, 70% experienced improvement in incontinence, and 69% experienced improvement in dementia. For the group showing 100% clinical improvement, the correlation coefficient of average changes in valve pressure over time (ΔP/ΔT) and average changes in ventricular volume over time (ΔV/ΔT) were high at 0.843 (P < 0.05). For the group experiencing no or only partial improvement, the correlation coefficient was 0.257 (P = 0.32), indicating no correlation between average ΔV/ΔT and average ΔP/ΔT for each patient. This was a carefully analyzed modeling study of idiopathic normal pressure hydrocephalus treatment made possible only by adjustable valve technology. With careful volumetric analysis, we found that changes in ventricular volume correlated with adjustments in valve pressure settings for those patients who improved clinically after shunting. This suggests that positive clinical responders retained parenchymal elasticity, emphasizing the importance of dynamic changes in this cohort. |
| Related Links | http://europepmc.org/articles/pmc1350579?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1350579/pdf https://academic.oup.com/neurosurgery/article-pdf/55/3/582/32574101/00006123-200409000-00011.pdf |
| Ending Page | 593 |
| Page Count | 12 |
| Starting Page | 582 |
| ISSN | 0148396X |
| DOI | 10.1227/01.neu.0000134385.23401.01 |
| Journal | Neurosurgery |
| Issue Number | 3 |
| Volume Number | 55 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2004-09-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Neurosurgery Pediatrics and Child Health Idiopathic Normal Pressure Hydrocephalus Programmable Shunt Ventricular Volume Ventriculoperitoneal Shunt |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) Surgery |
