Idiopathic Normal Pressure Hydrocephalus: Surgical Outcome of Endoscopic Third Ventriculostomy Comparing VP Shunt

Background: Normal-pressure hydrocephalus (NPH) affects the older people and the presentations are gait disturbance, incontinence and dementia. The reason is still unknown and there is increased CSF volume causing pressure to the periventricular brain causing the symptoms where there is no evidence of absorption failure or obstruction of the CSF pathway.

Aims: The main objective of this study is to compare the surgical outcome of endoscopic third ventriculostomy (ETV) and VP shunt (VPS) in NPH.

Methodology: A total of 24 patients were included in the study where 12 patients underwent ETV and 12 patients VPS. Patients having a definite cause of hydrocephalus and multiple co-morbid diseases were excluded from the study. Various Scoring systems were studied to see the efficiency of ETV.

Results: About 60% of patients were successfully recovered. 40% needed to revision surgery either VP shunt or LP shunt. Some scales showed higher effieciency of ETV.

Conclusion: ETV in NPH is a safe and effective procedure. Whether the CSF absorption is hampered at arachnoid granulation is doubtful for failure cases. ETV is a short procedure with a good success rate in selected patients.