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Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial.
Pinto, Fernando Campos Gomes; Saad, Felippe; Oliveira, Matheus Fernandes de; Pereira, Renan Muralho; Miranda, Fernanda Letkaske de; Tornai, Juliana Benevenuto; Lopes, Maria Izabel Romão; Ribas, Eduardo Santamaria Carvalhal; Valinetti, Emilia Aparecida; Teixeira, Manoel Jacobsen.
Afiliação
  • Pinto FC; Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil.
Neurosurgery ; 72(5): 845-53; discussion 853-4, 2013 May.
Article em En | MEDLINE | ID: mdl-23313977
BACKGROUND: Currently, the most common treatment for idiopathic normal pressure hydrocephalus (INPH) is a ventriculoperitoneal shunt (VPS), generally with programmable valve implantation. Endoscopic third ventriculostomy (ETV) is another treatment option, and it does not require prosthesis implantation. OBJECTIVE: To compare the functional neurological outcome in patients after 12 months of treatment with INPH by using 2 different techniques: ETV or VPS. METHODS: Randomized, parallel, open-label trial involving the study of 42 patients with INPH and a positive response to the tap test, from January 2009 to January 2012. ETV was performed with a rigid endoscope with a 30° lens (Minop, Aesculap), and VPS was performed with a fixed-pressure valve (PS Medical, Medtronic). The outcome was assessed 12 months after surgery. The neurological function outcomes were based on the results of 6 clinical scales: mini-mental, Berg balance, dynamic gait index, functional independence measure, timed up and go, and normal pressure hydrocephalus. RESULTS: There was a statistically significant difference between the 2 groups after 12 months of follow-ups, and the VPS group showed better improvement results (ETV = 50%, VPS = 76.9%). CONCLUSION: Compared with ETV, VPS is a superior method because it had better functional neurological outcomes 12 months after surgery.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ventriculostomia / Derivação Ventriculoperitoneal / Terceiro Ventrículo / Endoscopia / Hidrocefalia de Pressão Normal Tipo de estudo: Clinical_trials Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurgery Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ventriculostomia / Derivação Ventriculoperitoneal / Terceiro Ventrículo / Endoscopia / Hidrocefalia de Pressão Normal Tipo de estudo: Clinical_trials Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurosurgery Ano de publicação: 2013 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos