Document Detail


Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial.
MedLine Citation:
PMID:  23313977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Currently, the most common treatment for idiopathic normal pressure hydrocephalus (INPH) is a ventriculoperitoneal shunt (VPS), generally with programmable valve implantation. Endoscopic third ventriculostomy (ETV) is another treatment option, and it does not require prosthesis implantation.
OBJECTIVE: To compare the functional neurological outcome in patients after 12 months of treatment with INPH by using 2 different techniques: ETV or VPS.
METHODS: Randomized, parallel, open-label trial involving the study of 42 patients with INPH and a positive response to the tap test, from January 2009 to January 2012. ETV was performed with a rigid endoscope with a 30° lens (Minop, Aesculap), and VPS was performed with a fixed-pressure valve (PS Medical, Medtronic). The outcome was assessed 12 months after surgery. The neurological function outcomes were based on the results of 6 clinical scales: mini-mental, Berg balance, dynamic gait index, functional independence measure, timed up and go, and normal pressure hydrocephalus.
RESULTS: There was a statistically significant difference between the 2 groups after 12 months of follow-ups, and the VPS group showed better improvement results (ETV = 50%, VPS = 76.9%).
CONCLUSION: Compared with ETV, VPS is a superior method because it had better functional neurological outcomes 12 months after surgery.
Authors:
Fernando Campos Gomes Pinto; Felippe Saad; Matheus Fernandes de Oliveira; Renan Muralho Pereira; Fernanda Letkaske de Miranda; Juliana Benevenuto Tornai; Maria Izabel Romão Lopes; Eduardo Santamaria Carvalhal Ribas; Emilia Aparecida Valinetti; Manoel Jacobsen Teixeira
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Neurosurgery     Volume:  72     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-19     Completed Date:  2013-11-04     Revised Date:  2013-12-03    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  845-53; discussion 853-4     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Combined Modality Therapy / methods
Endoscopy / methods*
Female
Humans
Hydrocephalus, Normal Pressure / pathology*,  surgery*
Male
Middle Aged
Pilot Projects
Third Ventricle / surgery*
Treatment Outcome
Ventriculoperitoneal Shunt / methods*
Ventriculostomy / methods*
Comments/Corrections
Comment In:
Neurosurgery. 2013 Nov;73(5):908-10   [PMID:  24141398 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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