Ventriculoperitoneal shunt management in patients with normal pressure hydrocephalus and cerebral atrophy: A retrospective chart review.

OBJECTIVE

The objective of this study was to determine whether cerebral atrophy is associated with ventriculoperitoneal (VP) shunt overdrainage in patients with normal pressure hydrocephalus (NPH).

METHODS

A 3-year retrospective chart review included 100 patients diagnosed with NPH who underwent VP shunt implantation for treatment. Radiologist CT or MRI reports were analyzed for a description of brain atrophy before shunting and overdrainage complications after shunting. Patients were categorized into four groups based on the presence or absence of cerebral atrophy and overdrainage complications.

RESULTS

Shunt overdrainage complications, including subdural hygromas and subdural hematomas, were found to occur significantly more often ( p = .0012) in patients with cerebral atrophy (n = 83) than in patients without cerebral atrophy (n = 17).

CONCLUSION

In this study, adult patients with NPH who had cerebral atrophy before VP shunt placement were observed to have a higher frequency of overdrainage complications after placement, compared with patients who did not have cerebral atrophy preplacement.