Neurol. praxi. 2014;15(1):43-46

Selection of patients with normal pressure hydrocephalus for shunt placement

MUDr. Václav Vybíhal, Ph.D.¹, MUDr. Ing. Tomáš Svoboda¹, MUDr. Karel Máca, Ph.D.¹, MUDr. Marek Sova¹, MUDr. George Hanoun¹, prof. MUDr. Martin Smrčka, Ph.D., MBA¹, PhDr. Radka Neužilová Michalčáková, Ph.D.²

¹ Neurochirurgická klinika, LF MU a FN Brno

² Neurologická klinika, LF MU a FN Brno

Introduction: The authors present the possibility of using lumbar infusion test and external lumbar drainage in patients with normal pressure hydrocephalus to select patients for shunt placement.

Material and methods: 82 patients were indicated for the shunt implantation from 2003 to 2011. Their mean age was 66.8 years. The group included 44 (53.7 %) men and 38 women (46.3 %). Patients were tested by lumbar infusion test in 77 cases, by external lumbar drainage in 22 patients, and both the above mentioned tests were carried out in 17 subjects.

Results: Lumbar infusion test predicted correctly the effect of the surgery in 78.3 % and external lumbar drainage in 90.9 %. 5 patients with negative lumbar infusion test were improved after external lumbar drainage.

Conclusion: Lumbar infusion test and external lumbar drainage methods are useful in predicting the effect of shunt implantation, but the disadvantage is lower benefit as compared with external lumbar drainage. Therefore, in patients with negative lumbar infusion test or results close to the thereshold we recommend to complete diagnostic algorithm by external lumbar drainage.

Keywords: lumbar infusion test, external lumbar drainage, normal pressure hydrocephalus, shunt

Published: March 1, 2014  Show citation