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  • Title: Cerebrospinal fluid dynamics and long-term survival of the Strata valve in idiopathic normal pressure hydrocephalus.
    Author: Lundkvist B, Koskinen LO, Birgander R, Eklund A, Malm J.
    Journal: Acta Neurol Scand; 2011 Aug; 124(2):115-21. PubMed ID: 21039363.
    Abstract:
    OBJECTIVE: Cerebrospinal fluid (CSF) dynamics and long-term shunt survival of the Strata CSF shunt were evaluated in patients with idiopathic normal pressure hydrocephalus (INPH). SUBJECTS AND METHODS: Seventy-two patients with INPH received a Strata valve. A CSF infusion test, neuroimaging and video recording of gait were performed at baseline and at 6 months (n = 68) after surgery. Long-term shunt survivals were obtained from patient records. RESULTS: The shunt survival at 1 year was 94% and at 3 years 92.5%. Forty-nine patients (72%) had an improved gait. Two patients were improved despite non-functioning shunts, indicating a possible placebo response. Nineteen patients were not improved at the 6-month follow-up. The shunt tests revealed a functioning shunt in 12; thus, unnecessary shunt revisions could be avoided. Seventeen patients showed a siphoning effect. Shunt revisions were made in six patients. Eight hygromas/subdural hematomas were found. CONCLUSIONS: The long-term survival of the Strata valves was good, and a concern of complications is not a reason to exclude elderly with INPH from shunt surgery. Studies are needed to evaluate pros and cons of the anti-siphon device. Using a CSF shunt test, unnecessary shunt revisions may be avoided.
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