Effectiveness of anti-siphon devices in CSF shunts for preventing overdrainage in normal pressure hydrocephalus: a systematic review and meta-analysis.

INTRODUCTION

We conducted a systematic review and meta-analysis to compare the effectiveness of shunts with and without anti-siphon devices (ASDs) or other flow-regulating systems in preventing cerebrospinal fluid (CSF) overdrainage and its associated complications.

METHODS

Following established guidelines, we searched PubMed, Embase, Scopus, Cochrane, and Web of Science for clinical studies evaluating adult patients diagnosed with NPH who underwent CSF shunting with ASDs or flow-regulating valves, and included a control group of patients with standard CSF shunts lacking such mechanisms. Non-English studies, conference abstracts, and case reports were ineligible.

RESULTS

We included seven studies with 928 patients. Although most outcomes showed no statistically significant difference between the intervention and control groups, ASDs had reduced incidences of subdural hygroma (OR = 0.33; p = 0.0368) and subdural hematoma (RR = 0.35; p = 0.0014), indicating a clear benefit in preventing these adverse events.

CONCLUSION

ASDs significantly reduced the development of subdural hygroma and subdural hematoma, playing a vital role in preventing neurological sequelae.