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Comparison of outcomes between patients with idiopathic normal pressure hydrocephalus who received a primary versus a salvage shunt.

Publication ,  Journal Article
Moran, D; Hung, A; Vakili, S; Fialho, H; Jeon, L; Sankey, EW; Jusué-Torres, I; Lu, J; Goodwin, CR; Elder, BD; Rigamonti, D
Published in: J Clin Neurosci
July 2016

Placement of a ventriculoperitoneal (VP) shunt is the treatment of choice for communicating hydrocephalus; however, the extent to which VP shunting is able to relieve symptoms in patients who had previously been treated with cerebrospinal fluid diverting therapy at an outside institution remains unclear. A retrospective review of patients with idiopathic normal pressure hydrocephalus treated with VP shunts at a single institution between 1993 and 2013 was conducted. Patients were classified as having received a primary VP shunt if they had not been previously treated with a VP shunt, ventriculoatrial shunt, lumboperitoneal shunt, or endoscopic third ventriculostomy. Patients were classified as having received a salvage VP shunt if they had been previously treated by one of these four modalities at an outside institution prior to their presentation to our institution. There were 357 patients who received a primary shunt and 33 patients who received a salvage shunt. Patients who had a salvage shunt placed had significantly higher odds of requiring a future revision (54% versus 41%; odds ratio=2.85; 95% confidence interval [CI]: 1.24-6.57; p=0.014). Patients who received a salvage shunt had statistically significantly lower rates of gait improvement at 6months in comparison to patients who received a primary shunt (relative risk=0.35; 95% CI: 0.14-0.87; p=0.025). Despite these findings, there was no significant difference at last follow-up in improvement in gait, continence, and cognition, indicating that outcomes for patients requiring a salvage shunt were comparable to patients receiving a primary shunt.

Duke Scholars

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

July 2016

Volume

29

Start / End Page

117 / 120

Location

Scotland

Related Subject Headings

  • Ventriculostomy
  • Ventriculoperitoneal Shunt
  • Urinary Incontinence
  • Treatment Outcome
  • Salvage Therapy
  • Retrospective Studies
  • Reoperation
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged
 

Citation

APA
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ICMJE
MLA
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Moran, D., Hung, A., Vakili, S., Fialho, H., Jeon, L., Sankey, E. W., … Rigamonti, D. (2016). Comparison of outcomes between patients with idiopathic normal pressure hydrocephalus who received a primary versus a salvage shunt. J Clin Neurosci, 29, 117–120. https://doi.org/10.1016/j.jocn.2015.12.009
Moran, Dane, Alice Hung, Sharif Vakili, Hugo Fialho, Lee Jeon, Eric W. Sankey, Ignacio Jusué-Torres, et al. “Comparison of outcomes between patients with idiopathic normal pressure hydrocephalus who received a primary versus a salvage shunt.J Clin Neurosci 29 (July 2016): 117–20. https://doi.org/10.1016/j.jocn.2015.12.009.
Moran D, Hung A, Vakili S, Fialho H, Jeon L, Sankey EW, et al. Comparison of outcomes between patients with idiopathic normal pressure hydrocephalus who received a primary versus a salvage shunt. J Clin Neurosci. 2016 Jul;29:117–20.
Moran, Dane, et al. “Comparison of outcomes between patients with idiopathic normal pressure hydrocephalus who received a primary versus a salvage shunt.J Clin Neurosci, vol. 29, July 2016, pp. 117–20. Pubmed, doi:10.1016/j.jocn.2015.12.009.
Moran D, Hung A, Vakili S, Fialho H, Jeon L, Sankey EW, Jusué-Torres I, Lu J, Goodwin CR, Elder BD, Rigamonti D. Comparison of outcomes between patients with idiopathic normal pressure hydrocephalus who received a primary versus a salvage shunt. J Clin Neurosci. 2016 Jul;29:117–120.
Journal cover image

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

July 2016

Volume

29

Start / End Page

117 / 120

Location

Scotland

Related Subject Headings

  • Ventriculostomy
  • Ventriculoperitoneal Shunt
  • Urinary Incontinence
  • Treatment Outcome
  • Salvage Therapy
  • Retrospective Studies
  • Reoperation
  • Neurosurgical Procedures
  • Neurology & Neurosurgery
  • Middle Aged