From the Research
Normal Pressure Hydrocephalus (NPH) is a neurological disorder characterized by the accumulation of cerebrospinal fluid (CSF) in the brain, leading to increased pressure and subsequent damage to brain tissue, and is typically treated with ventriculoperitoneal shunt (VPS) placement, as shown in a study published in 2024 1.
Definition and Treatment of NPH
NPH is a condition that affects the brain, causing symptoms such as gait disturbance, cognitive impairment, and urinary incontinence. The treatment of NPH typically involves the placement of a VPS, which helps to divert excess CSF from the brain to the abdomen, where it can be absorbed.
Key Findings
- A study published in 2024 found that VPS placement is effective in treating NPH, with significant improvements in clinical and radiological outcomes, particularly in the short-term follow-up period 1.
- The study also found that the median opening pressure of the programmable valve was 120 mmH2O for women and 140 mmH2O for men, and that comorbidities such as diabetes mellitus and apoplexy correlated with surgical outcomes 1.
- Another study published in 2019 found that VPS placement is a safe and effective treatment for iNPH, with significant and lasting improvements in symptoms, particularly gait, and that strict follow-up is necessary for early diagnosis of shunt malfunction or need for valve adjustment 2.
Recommendations
- VPS placement should be considered as a treatment option for patients with NPH, particularly those with significant symptoms and evidence of CSF accumulation in the brain.
- The placement of a programmable VPS with a flow-regulated anti-siphon device valve may be preferred due to its ability to reduce the frequency of overdrainage and resulting complications, as shown in a study published in 2017 3.
- Patients with NPH should be closely monitored for signs of shunt malfunction or need for valve adjustment, and should undergo regular follow-up evaluations to assess the effectiveness of treatment and make any necessary adjustments.