Outcome & Recovery
If the cause of NPH is known, success rates can be as high as 80 percent. In cases in which a cause is not known, the success rate varies from 25 to 74 percent.
Neurosurgeons do not agree on the factors that lead to a successful shunting procedure nor do they have similar success rates. The higher success rates, however, have been reported from medical centers using the more demanding diagnostic tests such as lumbar catheters or the measurement of CSF outflow resistance. It is important to note that if initial success is followed by a recurrence of symptoms, it may be due to a shunt or shunt failure, the need for shunt pressure re-programming (in the case of a programmable shunt) or simply a lower pressure shunt rather than failure of the procedure.
Rate of Improvement
The symptoms of gait disturbance, mild dementia and bladder control problems may improve within days of shunt surgery, or may take weeks to months to abate. However, there is no way to predict how fast, or to what extent, this improvement will occur. For patients who do improve, changes are seen in the first week in most cases. In addition, this improvement may range from mild to dramatic. It is also not possible to make general predictions of how long the improvement will last, as the course of clinical improvement varies for each patient. Some patients seem to reach a plateau, while others improve for months but then seem to decline again. Unfortunately, there are no guarantees.
Generally, patients with an implanted shunt system are not restricted in their daily activities, except those involving great physical exertion. Your doctor will discuss with you any restrictions that may be advisable. Most patients with hydrocephalus can look forward to a normal future. Shunts are expected to perform reliably over a long period of time. However, because hydrocephalus is an ongoing condition, patients do require long term follow-up care by a doctor. Having regular medical checkups at intervals recommended by the neurosurgeon is sensible.
Occasionally, patients with shunt systems require revisions. A revision is a surgical procedure to modify, repair or replace a shunt system due to complications or changing patient conditions. In those cases where a change in shunt pressure is needed, a patient with a programmable shunt system will simply require their shunt to be externally (without surgery) re-programmed.
The patient or family of the patient must be responsible for follow-up care. Regular follow-up visits will help the neurosurgeon to identify any subtle changes that may be indicative of a shunt problem. Patients and family members should become familiar with the signs and symptoms of shunt malfunction as described below.
Some Symptoms of Shunt Malfunction
- Vision Problems
- Personality Change
- Loss of Coordination or Balance
- Difficulty in Waking Up or Staying Awake
- Return of Gait Disturbance
- Mild Dementia
This list of symptoms is for your reference only, and is not a diagnostic aid. If you are in doubt about your condition or a family member's medical condition, consult your physician immediately or click here to locate a specialist in your area.DSUS/COD/1014/0194