Prognostic Factors of Lumboperitoneal Shunt in Communicating Hydrocephalus

ABSTRACT

OBJECTIVE: A 10-year retrospective lumboperitoneal(LP) shunt surgery was reviewed in order to verify the several prognostic factors including the etiology, the findings of brain computed tomography(CT) and/or magnetic resonance imaging(MRI), and the effect of lumbar drainage which have been implicated in the result of LP shunt. PATIENTS AND MEHTODS A series of 32 patients who underwent LP shunt surgery between March 1988 and May 1998 for the management of communicating hydrocephalus was reviewed. RESULTS: The etiology of communicating hydrocephalus was subarachnoid hemorrhage(SAH) in 19 cases(59.4%), head trauma in 10 cases(31.2%), intracerebral hemorrhage in 2 cases(6.3%), meningitis in 1 case(3.1%), tumor in 1 case(3.1%), and idiopathic in 2 cases(6.3%). The mean follow-up period was 1.2 years(range, 2 week to 8.5 year). Among them, twenty four patients(75%) were clinically improved after shunt operation. The result of LP shunt was not related to the etiologies and many findings of brain CT/MRI such as ventricular index, Evan's index, periventricular low density, obliteration of cerebral sulci and cortical atrophy. However, the result of LP shunt was significantly related to the effect of preoperative lumbar drainage(p=0.0184). CONCLUSION: This result suggests that the effect of preoperative lumbar drainage has a significant role in predicting the result of LP shunt in patients with communicating hydrocephalus.