Programmable Ventriculo Peritoneal Shunt Outcomes of Normal Pressure Hydrocephalus: A Case Series of 10 Patients

Dr. Rohit Kamlesh Yadav, Dr. Aniruddha Chattopadhyay, Dr. Arijit Ghosh, Dr. Sabyasachi Saha

Abstract: Background: Patients with normal pressure hydrocephalus (NPH) may benefit from a programmable Ventriculoperitoneal shunt (VPS) to divert cerebrospinal fluid (CSF). This study aims to examine the results, complication rates, and predictors of Programmable VPS installation in patients with NPH. Methods: We retrospectively evaluated 10 patients with NPH (7 males and 3 females) who had Programmable VPS placement between January 2023 and June 2023. These individuals showed objective and/or subjective improvement following a lumbar drain experiment. Clinical improvement following shunting. Complications associated with the VPS operation were documented. Results: The study population had a mean age of 69 years (range: 50?80). The average duration of gait disturbance, cognitive impairment, and urine incontinence were 18.4, 15.4, and 13.4 months, respectively. Out of the 10 patients, 9 had a 4-week follow-up; among them, 7 reported improvements in gait, 4 in incontinence, and 1 in cognition. Gait improvement was more significant compared to improvements in incontinence or cognition. A shorter length of gait disruption predicted greater gait improvement following shunting. Patients taking cognitive-enhancing medicines were more likely to report improvement in cognition and/or incontinence following shunting. Complications included misplaced proximal catheters (n-1), asymptomatic catheter tract Infection (n -2), subdural hematomas (n-1), CSF leak (n-0), and post-op mortality (n-1). Conclusion: Programmable VPS installation in patients with NPH is well tolerated and linked with better results in the short-term follow-up period (<6 months). A shorter period of gait disturbance and the use of cognition-enhancing medicines are predictors of improved recovery following shunting.

Keywords: normal pressure hydrocephalus (NPH), ventriculoperitoneal shunt (VPS), cerebral spinal fluid (CSF), outcome, complications