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Abstract Details

Efficacy and Complications of Lumboperitoneal Shunt for Idiopathic Normal Pressure Hydrocephalus in Elderly Patients: A Systematic-review and Meta-analysis
Aging, Dementia, Cognitive, and Behavioral Neurology
P11 - Poster Session 11 (5:30 PM-6:30 PM)

INPH, the most common form of hydrocephalus in adults, is a syndrome that can potentially be reversed by cerebrospinal fluid shunt. It is marked by a set of complex symptoms, with unexplained symmetric gait disturbance being the primary symptom. LPS is one of the recommended shunt types for iNPH. However, the benefits of LPS are conflicting in the literature.

We sought to perform a Systematic Review and Meta-analysis to assess the functional outcomes of Lumboperitoneal shunt (LPS) in patients ≥ 60 years of age with Idiopathic Normal Pressure Hydrocephalus (iNPH).

MEDLINE, Embase, and Cochrane were searched for RCTs and prospective studies that directly compared patients before and after LPS surgery. Studies were analyzed based on the following endpoints: Mini-Mental State Exam (MMSE), Evan’s Index, subdural hematoma events, infection, and shunt malfunction. Data was examined using the Mantel-Haenszel method and 95% confidence intervals (CIs). Heterogeneity was assessed using I² statistics. The Baujat plot was used to estimate the individual heterogeneity of each included study.

Seven studies and 809 patients were included. Evan’s Index was significantly better in the post-shunt group (MD 0.0272; 95% CI 0.0012–0.0533; p=0.04; I² =75%). MMSE (MD -0.5656; 95% CI -1.3166–0.1854; p=0.1; I² = 0%), subdural hematoma events (Proportion 0.05; 95% CI 0.03–0.07; p=0.39; I² = 1%), shunt infection (Proportion 0.01; 95% CI 0.00–0.03; p=0.41; I² =0%), and shunt malfunction (Proportion 0.03; 95% CI 0.02–0.05; p=0.85; I² =0%) endpoints did not show any statistically significant difference between groups.

This meta-analysis suggests that LPS may be an efficient intervention for iNPH in patients ≥ 60 years old, given the decrease in the Evan Index, a scale that measures the degree of ventricular distention. 

Artur Menegaz de Almeida
Mr. Menegaz de Almeida has nothing to disclose.
Gabriel Marinheiro Dos Santos-Bezerra No disclosure on file
Carlos Alberto Campello No disclosure on file
Ítalo B. Andrade Mr. Andrade has nothing to disclose.
Lucca Moreira Lopes No disclosure on file
Victória Siebel No disclosure on file
Allan Polverini No disclosure on file