Abstract | BACKGROUND: OBJECTIVE: To evaluate the usefulness of VPS and ETV in the treatment of PTH and to establish the indications for their usage. MATERIALS AND METHODS: This was an ambispective study of 141 patients who developed PTH out of 2500 cases of TBI treated during the study duration (2012-2016). These patients were segregated into two groups depending on the primary procedure for PTH-ETV group and VPS group. The two groups were compared to analyze the differences in radiological and clinical outcome. RESULTS: 141 patients were included in the study and 175 procedures were performed in these patients. ETV group had 30 procedures and VPS had 145 procedures. In the ETV group, 37% of cases showed improvement v/s 73% cases in the VPS group. A statistically significant number of patients had improvement in presenting symptoms in the VPS group, as compared with the ETV group (P = 0.001). There was no significant difference in Glasgow coma scale (GCS) at discharge (P = 0.15) and Glasgow outcome score at 6 months of follow-up (P = 0.22) between the two groups. Poor GCS, previous cerebrospinal fluid infection, and postoperative meningitis were found to have significant effect on the failure-free period of the procedure. On comparing the probabilities of failure-free period of ETV v/s VPS, the chances of VPS failure are 61% lesser than ETV. CONCLUSIONS: VPS is an effective modality for the management of PTH and has a much lower failure rate as compared to ETV. However, ETV can be considered as a salvage procedure in difficult situations of recurrent shunt malfunction or infection.
|
Authors | Raghavendra Sharma, Ravi Sharma, Vivek Tandon, Manoj Phalak, Kanwaljeet Garg, Manmohan Singh, Deepak Gupta, Deepak Agrawal, Sarat P Chandra, Shashank Sharad Kale, V Sreenivas |
Journal | Neurology India
(Neurol India)
2020 Sep-Oct
Vol. 68
Issue 5
Pg. 1125-1132
ISSN: 1998-4022 [Electronic] India |
PMID | 33109862
(Publication Type: Journal Article)
|
Topics |
- Algorithms
- Humans
- Hydrocephalus
(etiology, surgery)
- Neuroendoscopy
- Third Ventricle
(surgery)
- Treatment Outcome
- Ventriculoperitoneal Shunt
- Ventriculostomy
|