Background: In treating idiopathic normal pressure hydrocephalus (INPH) with a shunt there is always a risk of underdrainage or overdrainage. The hypothesis is tested whether patients treated using an adjustable valve preset at the highest opening pressure leads to comparable good clinical results with less subdural effusions than in a control group with an opening pressure preset at a low pressure level.
Methods: A multicentre prospective randomised trial was performed on a total of 58 patients suspected of INPH. Thirty patients were assigned to (control) group 1 and received a Strata shunt (Medtronic, Goleta, USA) with the valve preset at a performance level (PL) of 1.0, while 28 patients were assigned to group 2 and received a Strata shunt with the valve preset at PL 2.5. In this group the PL was allowed to be lowered until improvement or radiological signs of overdrainage were met.
Results: Significantly more subdural effusions were observed in the improved patients of group 1. There was no statistically significant difference in improvement between both groups overall.
Conclusions: On the basis of this multicentre prospective randomised trial it is to be recommended to treat patients with INPH with a shunt with an adjustable valve, preset at the highest opening pressure and lowered until clinical improvement or radiological signs of overdrainage occur although slower improvement and more shunt adjustments might be the consequence.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/jnnp-2012-302935 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Application of preset coronary artery orifice patch in Bentall surgery.
J Cardiothorac Surg
September 2024
Department of Cardiovascular Surgery, Second Afliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China.
Background: Bentall surgery is the main method for treating aortic root lesions, but traditional Bentall method is very difficult for patients with mild aortic sinus dilation to directly anastomose the coronary artery orifice with graft.
Case Presentation: A 41-year-old man was admitted to hospital after severe chest pain. Computed tomography angiography(CTA)revealed a type A aortic dissection.
A Real-Time Intelligent Valve Monitoring Approach through Cameras Based on Computer Vision Methods.
Sensors (Basel)
August 2024
School of Chemical Engineering, Sichuan University, Chengdu 610065, China.
Abnormal valve positions can lead to fluctuations in the process industry, potentially triggering serious accidents. For processes that frequently require operational switching, such as green chemical processes based on renewable energy or biotechnological fermentation processes, this issue becomes even more severe. Despite this risk, many plants still rely on manual inspections to check valve status.
View Article and Find Full Text PDFAnalysis of the hemostatic effect of preset wrapping technique for type A aortic dissection with abnormal coagulation.
J Thorac Dis
February 2024
Department of Cardiovascular Surgery, General Hospital of Southern Theater Command, PLA (People's Liberation Army), Guangzhou, China.
Background: There are many techniques to reduce anastomotic bleeding for the total arch replacement, but hemostasis is sometimes difficult to achieve after surgery for acute dissection, especially in patients with abnormal coagulation (AC). This study aimed to investigate the hemostatic effect and early efficacy of a pre-set bovine pericardium wrapper in the right heart system shunt for total arch replacement in patients with type A aortic dissection (TAAD) and preoperative AC.
Methods: A retrospective analysis was conducted on 85 patients with TAAD and AC who underwent total arch replacement between January 2018 and December 2022.
Comparison of Efficacy of Pressure Controlled vs. Traditional Manual Mask Ventilation for Newborn Resuscitation - A Simulation-Based Pilot Randomized Control Trial.
Indian J Pediatr
October 2024
Department of Research, Deenanath Mangeshkar Hospital, Pune, India.
Objectives: To determine efficacy of non-invasive positive pressure face mask ventilation using a ventilator device (NIPPmV) for achieving early effective ventilation compared to that by self-inflating bag (SIB) or T- piece resuscitator (TPR).
Methods: The authors video recorded 33 trained resuscitators using NIPPmV (provided using ventilator device), SIB [a 500 ml silicone SIB without a positive end expiratory pressure (PEEP) valve] and a TPR. Using a continuous pressure recording system and a neonatal manikin, the authors evaluated the efficacy of the ventilation to achieve early effective ventilation during 30 s of ventilation.
Simultaneous surgery of an inflammatory abdominal aortic aneurysm and renal cell carcinoma: A case report.
Int J Surg Case Rep
November 2023
Department of General and Vascular Surgery, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran. Electronic address:
Introduction: Abdominal aortic aneurysm (AAA) and renal cell carcinoma (RCC) coincidence is considered a rare phenomenon. Moreover, the inflammatory nature of aneurysm increases the rarity of the case.
Presentation Of Case: Our case was a 66-year-old man complaining of constant abdominal pain with a periumbilical pulsatile mass on examination.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!