Prospective analysis by computed tomography and long-term outcome of 23 adult patients with chronic idiopathic hydrocephalus.
From 1986 to 1989, 23 adult patients (average age, 70 yr) with idiopathic chronic hydrocephalus received shunts with medium-pressure Pudenz-Schulte valves for suspected normal pressure hydrocephalus. Prospective clinical and computed tomographic monitoring was continued for at least 5 years. We observed the formation of a hypodense subdural collection in each of 10 patients (43%). Those collections that occurred early, i.e., within the first 9 postoperative days, evolved differently from those that occurred late; only early hypodense collections became subdural hematomas (three cases). In one case, a subdural hematoma was already present 9 days after surgery, so that four patients (17%) presented a subdural hematoma within the first 2 postoperative months. Our long-term follow-up revealed three patients (13%) with hypodense subdural collections, which appeared more than 2 months after surgery. None of the collection evolved into a subdural hematoma. Thirteen patients (57%) died between 9 and 68 months (average, 20 mo) after surgery, most often of an ischemic stroke. During the 1st postoperative year, there was improvement in the condition of 22 patients (96%) who had received a ventricular shunt; 21 of these patients (91%) remained improved until death or for at least 5 years.
Raftopoulos
C
C
Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Belgium.
Massager
N
N
Balériaux
D
D
Deleval
J
J
Clarysse
S
S
Brotchi
J
J
D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002557:Cerebrospinal Fluid Shunts; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006408:Hematoma, Subdural; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000401:mortality; D011446:Prospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome