ArticleActa neurochirurgica2026
Reduced risk of shunt revision with adjustable valves: a population-based cohort study over three decades.
Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundIdiopathic normal pressure hydrocephalus (iNPH) is a neurological disease characterized by ventriculomegaly and Hakim's triad. At present, symptoms can be alleviated only by cerebrospinal fluid (CSF) shunt surgery. Yet, various complications after shunting may occur, occasionally requiring repeated shunt revisions. In this retrospective, population-based study, our objective was to compare revision rates and causes for revision surgeries between adjustable shunt valve and fixed-pressure valves in iNPH patients.
methodsAltogether 1220 patients were evaluated for possible iNPH at Kuopio University Hospital between 1991 and 2023. Probable iNPH was diagnosed in 809 patients who received their first ventriculoperitoneal shunt (VPS). Of the patient cohort, 566 were shunted using an adjustable valve (2008-2023) and 243 received a fixed pressure valve (1991-2012). Hospital records and nationwide registries were used to construct a timeline for each patient from the shunt insertion and until death (n = 430) or the end of 2023.
resultsOverall revision rate was lower in iNPH patients receiving an adjustable valve (14% vs. 30%, p < .001, 95% CI 0.27-0.56). The incidence of multiple revisions was also lower in the adjustable valve group (27% vs. 32% p = 0.002, 95% CI 0.21-0.71). The most common cause for revision was peritoneal catheter malposition in the adjustable valve group (44%) and shunt underdrainage in the fixed-pressure valve group (25%).
conclusionsAdjustable shunt valves have decreased the need for shunt revision surgeries due to under- and overdrainage.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.