Ventriculoperitoneal shunt management in patients with normal pressure hydrocephalus and cerebral atrophy

Objective: The objective of this study was to determine whether cerebral atrophy is associated with ventriculoperitoneal (VP) shunt overdrainage in patients with normal pressure hydrocephalus (NPH). Methods: A 3-year retrospective chart review included 100 patients diagnosed with NPH who underwent VP shunt implantation for treatment. Radiologist CT or MRI reports were analyzed for a description of brain atrophy before shunting and overdrainage complications after shunting. Patients were categorized into four groups based on the presence or absence of cerebral atrophy and overdrainage complications. Results: Shunt overdrainage complications, including subdural hygromas and subdural hematomas, were found to occur significantly more often ( p = .0012) in patients with cerebral atrophy (n = 83) than in patients without cerebral atrophy (n = 17). Conclusion: In this study, adult patients with NPH who had cerebral atrophy before VP shunt placement were observed to have a higher frequency of overdrainage complications after placement, compared with patients who did not have cerebral atrophy preplacement.