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Cerebrospinal fluid dynamics and long-term survival of the Strata(®) valve in idiopathic normal pressure hydrocephalus.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
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2011 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 124, no 2, 115-121 p.Article in journal (Refereed) Published
Abstract [en]

Objective -  Cerebrospinal fluid (CSF) dynamics and long-term shunt survival of the Strata(®) CSF shunt were evaluated in patients with idiopathic normal pressure hydrocephalus (INPH). Subjects and methods -  Seventy-two patients with INPH received a Strata(®) valve. A CSF infusion test, neuroimaging and video recording of gait were performed at baseline and at 6 months (n = 68) after surgery. Long-term shunt survivals were obtained from patient records. Results -  The shunt survival at 1 year was 94% and at 3 years 92.5%. Forty-nine patients (72%) had an improved gait. Two patients were improved despite non-functioning shunts, indicating a possible placebo response. Nineteen patients were not improved at the 6-month follow-up. The shunt tests revealed a functioning shunt in 12; thus, unnecessary shunt revisions could be avoided. Seventeen patients showed a siphoning effect. Shunt revisions were made in six patients. Eight hygromas/subdural hematomas were found. Conclusions -  The long-term survival of the Strata(®) valves was good, and a concern of complications is not a reason to exclude elderly with INPH from shunt surgery. Studies are needed to evaluate pros and cons of the anti-siphon device. Using a CSF shunt test, unnecessary shunt revisions may be avoided.

Place, publisher, year, edition, pages
Wiley , 2011. Vol. 124, no 2, 115-121 p.
Keyword [en]
normal pressure hydrocephalus, cerebrospinal fluid shunt, cerebrospinal fluid outflow conductance, cerebrospinal fluid infusion test, intracranial pressure
Identifiers
URN: urn:nbn:se:umu:diva-40870DOI: 10.1111/j.1600-0404.2010.01432.xPubMedID: 21039363OAI: oai:DiVA.org:umu-40870DiVA: diva2:403261
Available from: 2011-03-11 Created: 2011-03-11 Last updated: 2017-12-11Bibliographically approved

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Lundkvist, BoKoskinen, Lars-OweBirgander, RichardEklund, AndersMalm, Jan

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