Background: After ventriculoperitoneal shunt surgery for normal pressure hydrocephalus (NPH), a certain per- centage of patients develop secondary clinical deteriora- tion after the initial improvement of clinical symptoms due to the development of mechanical and infectious complications. The aim of this study is to analyze the frequency of these complications and the way they were resolved in our institution.
Methods: For this research, we conducted a retrospec- tive case series of 76 patients who were treated for nor- motensive hydrocephalus (NPH) in the period from 2010 to 2020 in the Department of Neurosurgery of the Clin- ical Center yemun. The study included 47 patients who underwent VP drainage with medium pressure valve due to idiopathic normotensive hydrocephalus (iNPH) and 29 patients with secondary normotensive hydrocephalus (sNPH). As mechanical complications, we considered overdrainage and shunt malfunction, while infectious complications included infection of the operative site and meningitis. For the comparison of infectious and me- chanical complications, for both groups of patients, we used methods of inferential statistics.
Results: The average age of patients operated on for iNPH was 72 years, while the average age of patients with VP shunt for sNPH was 64 years. Out of a total of 76 analyzed patients, 24 or 31.5% of patients had one of the mentioned complications. The infection rate in patients with shunt surgery for iNPH was 1.4%, and in patients with sNPH it was 3.7%. In total, 15 (31.9%) patients op- erated on for iNPH had mechanical complications during 6 months of follow-up that required re-hospitalization and treatment, of which 11 (23.4%) were overdrainage, and 4 (8.51%) were shunt malfunctions. In patients op- erated on for sNPH, only 5 (17.2%) patients had me- chanical complications, of which 2 (6.89%) in the form of overdrainage and 3 (10.3%) due to shunt malfunction. The analysis of age and mechanical complications indi- cated a statistically significant difference (p<0.05) in the rates of mechanical complications of patients with iNPH and sNPH, as well as regarding the age of the patients.
Conclusion: Analyzing our series we came to the con- clusion that the rate of mechanical complications is sta- tistically significantly higher in the group of patients with iNPH, as well as that patients age.
