Utilization of a Telemetric Prechamber in the Management of Patients with Normal Pressure Hydrocephalus.

BACKGROUND AND

OBJECTIVES

Normal pressure hydrocephalus is a preventable and treatable cause of dementia. A telemetric prechamber allows individually tailored ventriculoperitoneal shunt valve adjustments in patients treated with the shunting procedure.

METHODS

In this pilot, prospective randomized trial, 33 adult patients were divided into Group A (with an implanted telemetric prechamber) and Group B (without an implanted telemetric prechamber). The overall condition, Mini-Mental-State-Examination score, and gait test were evaluated 3, 6, 9, and 12 months after surgery. Additionally, the total number of ventriculoperitoneal shunt valve adjustments and their impact on the patient's condition (assessed by the idiopathic normal pressure hydrocephalus scale) were assessed.

RESULTS

There were no differences in the proportion of patients showing improved gait, cognitive functions, or incontinence. Patients with a telemetric prechamber underwent significantly more valve adjustments (1.6 ± 1.1 vs. 0.8 ± 0.6; P = 0.037). Also, a greater difference (reduction) in the shunt initial and final valve setting was observed in the prechamber group (30.71 ± 24.95 vs. 15.26 ± 13.07 mm H2O; P = 0.049).

CONCLUSIONS

A telemetric prechamber allowed more valve adjustments during the follow-up period and a greater difference (reduction) between the initial (perioperative) and final valve pressure settings. However, there was no difference in functional parameters between the groups at any time point of the study.