Evidence map›Paper›PMID 39779494›Full record

ArticleActa neurochirurgica2025

When and how are complications suspected after shunt surgery in patients with normal pressure hydrocephalus?

Johan Virhammar, Oskar Fasth, Fredrik Vedung

Abstract read
In one paragraph

Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Johan VirhammarDepartment of Medical Sciences, Neurology, Uppsala University, Akademiska Sjukhuset, ing 85, Uppsala, 751 85, Sweden. johan.virhammar@neuro.uu.se.ORCID 0000-0001-9901-2949
Oskar FasthDepartment of Medical Sciences, Neurology, Uppsala University, Akademiska Sjukhuset, ing 85, Uppsala, 751 85, Sweden.
Fredrik VedungDepartment of Medical Sciences, Neurosurgery, Uppsala University, Uppsala, Sweden.

Funding

Svenska Sällskapet för Medicinsk Forskning SG-22-0192-H-01
6 · The paper itself

Abstract

purposeThe follow-up routine for patients with idiopathic normal pressure hydrocephalus (iNPH) after shunt surgery differs across medical centers. Shunt surgery is not without risks, with complications emerging at various times after the procedure. The aim was to explore the timing and methods of detecting complications following ventriculoperitoneal shunt surgery for iNPH.

methodsThis retrospective study examined patients who underwent shunt surgery for iNPH at Uppsala University Hospital between 2011 and 2018. The cohort comprised 491 patients. Postoperative complications within the first 12 months were recorded from medical records. Complications were classified by type, and the method or event that first indicated the complication was documented.

resultsOf the 491 patients, 102 (20.8%) experienced complications during the one-year follow-up period, with a shunt revision rate of 15.5% (76 patients requiring reoperation). Subdural hematomas/hygromas were the most common complications, with 27 cases; only three required surgical intervention. Most complications were identified through additional appointments triggered by patient-reported symptoms (31.4%), while the planned follow-up routine with CT scans and planned follow-up visits together accounted for 56% of the detections. The 3-month and 12-month follow-up visits detected similar proportions of complications (12.7% and 11.8%, respectively).

conclusionThe majority of the complications were detected at a planned visit or investigation. Given the cognitive impairments in iNPH patients and that signs of shunt dysfunction can be subtle, a structured follow-up routine is important for timely detection of complications. The findings suggest that both CT scans and planned follow-up visits are critical components of effective postoperative monitoring.

Indexed as

Hydrocephalus, Normal PressurePostoperative ComplicationsReoperationVentriculoperitoneal ShuntAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTomography, X-Ray Computed

Identifiers

PMID39779494
PMCPMC11711697

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