Abstract
Background The current treatment of choice for Normal Pressure Hydrocephalus (NPH) is a CSF shunt, however, this carries significant morbidity with reported complication rates following shunt surgery averaging 38%, with a 6% rate of permanent neurological deficit or death [1]. NPH can be viewed as a slowly progressive communicating hydrocephalus. Endoscopic coagulation of the choroid plexus (CPC) has been shown to be an effective treatment of communicating hydrocephalus in children, particularly when it is slowly progressing. It has not yet been evaluated in adults with NPH. Endoscopic third ventriculostomy (ETV) has been shown to be effective in selected cases of NPH. Published results of both endoscopic techniques suggest that complication rates are lower than for CSF shunt surgery. A combination of endoscopic CPC and ETV may provide an attractive alternative to CSF shunting with equivalent rates of responsiveness and lower surgical morbidity. The aim of this study is to evaluate the effectiveness of endoscopic treatment of NPH compared to CSF shunting.
Highlights
The current treatment of choice for Normal Pressure Hydrocephalus (NPH) is a CSF shunt, this carries significant morbidity with reported complication rates following shunt surgery averaging 38%, with a 6% rate of permanent neurological deficit or death [1]
Endoscopic third ventriculostomy (ETV) has been shown to be effective in selected cases of NPH. Published results of both endoscopic techniques suggest that complication rates are lower than for CSF shunt surgery
A combination of endoscopic CPC and ETV may provide an attractive alternative to CSF shunting with equivalent rates of responsiveness and lower surgical morbidity
Summary
A prospective, randomised, controlled trial to evaluate the efficacy and safety of endoscopic choroid plexus coagulation with third ventriculostomy in the treatment of idiopathic normal pressure hydrocephalus [ISRCTN29863839]. Address: 1Departments of Neurosurgery, Frenchay Hospital, Bristol, UK, 2Departments of Neuropsychology, Frenchay Hospital, Bristol, UK and 3Department of Neurological Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA. Cerebrospinal Fluid Research 2004, 1(Suppl 1):S58 doi:10.1186/1743-8454-1-S1-S58. 48th Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida Meeting abstracts
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