Clinical parameters in 74 consecutive patients shunt operated for normal pressure hydrocephalus

Acta Neurol Scand. 1991 Dec;84(6):475-82. doi: 10.1111/j.1600-0404.1991.tb04998.x.


Seventy four consecutive patients diagnosed as normal pressure hydrocephalus (NPH) and operated with a ventriculo-peritoneal shunt were followed prospectively for an average of 2.1 years. The mean age was 64 years. The effect of the operation was estimated by calculating 6 indices expression social functioning, neurological signs, gait ability, continence, psychometric performance and psychiatric condition. Ninety-six % had mental symptoms, 95% gait disturbances and 75% incontinence. Improvement was observed in 78% after shunt surgery, while 22% deteriorated. Psychiatric improvement was seen in 80% and 76% improved in gait ability. Improvement was highest in the group caused by subarachnoid hemorrhage (98%) while 73% with idiopathic NPH improved. Old age was not correlated to poorer response, while long-standing pre-operative symptoms yielded worse results. No single symptom or sign could predict a positive outcome of the operation. Eleven % of the patients could leave long-term care institutions and there was a 36% reduction of aid in daily living. Complications to shunt surgery were observed in 50% of the patients and shunt related mortality was 1%. Shunt malfunction was the most frequent complication (31%) followed by infection (19%). Epilepsy developed in 9% after surgery. All shunt complication except one appeared within the first year after surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebrospinal Fluid Shunts*
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus, Normal Pressure / diagnosis
  • Hydrocephalus, Normal Pressure / surgery*
  • Male
  • Middle Aged
  • Neurocognitive Disorders / diagnosis
  • Neurologic Examination*
  • Neuropsychological Tests
  • Postoperative Complications / diagnosis*
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / surgery