LUMBOPERITONEAL SHUNTING IN PATIETNS WITH NORMAL PRESSURE HYDROCEPHALUS

Objective; To determine the efficacy of lumboperitoneal shunting in cases presenting with normal pressure hydrocephalus. Methodology: This was a cases series study, conducted at LGH Lahore during January 2017 to December 2017. In this study the cases of NPH of either gender and age range of 15 years or more were included. The diagnosis of NPH was made according to clinical signs and symptoms on Mini mental status examination and Modfied Rankin Score in cases with ventriculomegaly on CT brain plain and with normal opening pressure of 70-245 mm of H2O on LP. The cases with with non communicating hydrocephalus and with meningitis were excluded. The lumbo peritoneal shunt was placed. Then these were followed for a period of 6 months and efficacy was labelled as yes where there was reduction of 50% of signs and symptoms either on mini mental status examination or modified Rankin score done at baseline. Results: In the present study, 30 cases of normal pressure hydrocephalus were selected. Out of these 30, there were 17 (56.67%) males and 13 (43.33%) females. The mean age was 54.53 +/- 6.34 years. The mean mini mental status score and modified Rankin score were 1.76 +/- 0.97 and 2.47 +/- 1.21 respectively. The efficacy of LP shunt in NPH was seen in 25 (83.33%) of cases. There was no case of shunt occlusion seen at 6 months and there was no major side effect observed. Conclusion: LP shunt is highly efficacious in cases of normal NPH and this is seen in every 8th cases treated with this.