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Related Experiment Video

Updated: Sep 13, 2025

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Time Course of Symptoms in Normal-Pressure Hydrocephalus: A Systematic Review.

Bekir Rovčanin1,2, Ibrahim Omerhodžić1,2, Adem Nuhović3

  • 1Department of Neurosurgery, Clinical Center University of Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina.

Diagnostics (Basel, Switzerland)
|July 29, 2025
PubMed
Summary

Ventriculoperitoneal shunting effectively treats normal-pressure hydrocephalus (NPH). However, the impact of symptom duration on surgical outcomes in NPH patients remains unclear, necessitating further research.

Keywords:
idiopathic normal-pressure hydrocephaluspostoperative outcomesprognostic factorssymptom durationventriculoperitoneal shunt

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Area of Science:

  • Neurology
  • Neurosurgery
  • Geriatrics

Background:

  • Idiopathic normal-pressure hydrocephalus (NPH) is a challenging elderly condition with gait, cognitive, and urinary symptoms.
  • Ventriculoperitoneal (VP) shunting is a known treatment for NPH.
  • The influence of symptom duration on VP shunting outcomes in NPH is not well-established.

Purpose of the Study:

  • To systematically review the literature on symptom duration in normal-pressure hydrocephalus (NPH) patients.
  • To evaluate the association between preoperative symptom duration and postoperative outcomes following VP shunting for NPH.

Main Methods:

  • A systematic literature search was performed across PubMed, Scopus, and Embase databases.
  • Included studies assessed clinical or radiological outcomes of VP shunting in adult NPH patients with reported symptom duration and at least one-month follow-up.
  • Clinical outcomes were qualitatively analyzed due to heterogeneity.

Main Results:

  • Twenty-four studies involving 1169 NPH patients were analyzed (mean age 72.45 years, mean symptom duration 33.04 months).
  • Most studies indicated clinical improvement after VP shunting.
  • Findings on the correlation between symptom duration and outcomes were inconsistent; some suggested better results with shorter duration, while others found no clear link.

Conclusions:

  • Ventriculoperitoneal shunting is an effective treatment for normal-pressure hydrocephalus.
  • Current evidence on the predictive value of preoperative symptom duration for VP shunting outcomes in NPH is inconclusive.
  • Standardized diagnostic protocols and prospective studies are needed to clarify the role of symptom duration and optimize surgical timing in NPH management.