There is no evidence to indicate whether placement of a shunt to remove fluid is effective in the management of normal pressure hydrocephalus

Esmonde T, Cooke S

Published Online:

January 21, 2009

Normal pressure hydrocephalus is a rare but potentially treatable cause of dementia. Since the condition was first described in 1965, it has conventionally been treated by placement of a shunt to remove cerebrospinal fluid (CSF) from the ventricles of the brain. No trial has yet compared the placement of a shunt versus no shunt in a randomized controlled manner. Nor have the long-term outcomes of treated and untreated normal pressure hydrocephalus been compared. There is, therefore, no evidence for the use of shunts in the management of normal pressure hydrocephalus.

Abstract (click to read)

Background:

Since the condition was first described in 1965, the syndrome of normal pressure hydrocephalus (NPH) has conventionally been managed by placement of a cerebrospinal fluid (CSF) shunt.

Objectives:

To determine the effectiveness of shunting procedures in promoting stability or improvement in the neurological symptoms and signs of NPH.

Search strategy:

The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 27 March 2008 using the terms: "Shunt*" AND "normal pressure hydrocephalus". The CDCIG Specialized Register contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trials databases and grey literature sources.

Selection criteria:

Studies included for analysis were those involving the placement of a CSF shunt for the treatment of NPH as part of a randomized controlled trial.

Data collection and analysis:

No data matching the selection criteria were found.

Main results:

No randomized controlled trials of shunt placement versus no shunt were found.

Authors' conclusions:

There is no evidence to indicate whether placement of a shunt is effective in the management of NPH.

This record should be cited as:

Esmonde T, Cooke S. Shunting for normal pressure hydrocephalus (NPH). Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD003157. DOI: 10.1002/14651858.CD003157

Assessed as up to date:

September 6, 2008

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Primary Review Group:

Dementia and Cognitive Improvement Group

Health topics:

Mental health > Dementia & cognition > Interventions aimed at interrupting disease processes

Neurology > Dementia & cognition > Interventions aimed at interrupting disease processes

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

There is no evidence to indicate whether placement of a shunt to remove fluid is effective in the management of normal pressure hydrocephalus

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