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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(01): 55-61
DOI: 10.1590/0004-282X20150190
Article

Performance of the fixed pressure valve with antisiphon device SPHERA® in the treatment of normal pressure hydrocephalus and prevention of overdrainage

Efeito da válvula de pressão fixa com antisifão SPHERA® no tratamento da hidrocefalia de pressão normal e prevenção de hiperdrenagem
Renan M. Pereira
1   Universidade Anhembi Morumbi, Sao Paulo SP, Brazil;
,
Mariane T. Suguimoto
1   Universidade Anhembi Morumbi, Sao Paulo SP, Brazil;
,
Matheus F. Oliveira
2   Hospital do Servidor Público Estadual de São Paulo, Departamento de Neurocirurgia, Sao Paulo SP, Brazil;
,
Juliana B. Tornai
3   Universidade de São Paulo, Hospital das Clínicas, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Hidrodinâmica Cerebral, Sao Paulo SP, Brazil;
,
Ricardo A. Amaral
4   Universidade de São Paulo, Hospital das Clínicas, Instituto de Psiquiatria, Grupo de Estudos sobre Álcool e Drogas, Sao Paulo SP, Brazil;
,
Manoel Jacobsen Teixeira
3   Universidade de São Paulo, Hospital das Clínicas, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Hidrodinâmica Cerebral, Sao Paulo SP, Brazil;
5   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Sao Paulo SP, Brazil;
,
Fernando Campos Gomes Pinto
3   Universidade de São Paulo, Hospital das Clínicas, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Hidrodinâmica Cerebral, Sao Paulo SP, Brazil;
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ABSTRACT

Normal pressure hydrocephalus (NPH) is characterized by the triad of gait apraxia, dementia and urinary incontinence associated with ventriculomegaly and normal pressure of cerebrospinal fluid. Treatment is accomplished through the implantation of a ventricular shunt (VPS), however some complications are still frequent, like overdrainage due to siphon effect. This study analyses the performance of a valve with anti-siphon device (SPHERA®) in the treatment of patients with NPH and compares it with another group of patients with NPH who underwent the same procedure without anti-siphon mechanism (PS Medical® valve). 30 patients were consecutively enrolled in two groups with 15 patients each and followed clinically and radiologically for 1 year. Patients submitted to VPS with SPHERA® valve had the same clinical improvement as patients submitted to VPS with PS Medical®. However, complications and symptomatology due to overdrainage were significantly lower in SPHERA® group, suggesting it as a safe tool to treat NPH.

RESUMO

A hidrocefalia de pressão normal (HPN) é caracterizada pela tríade de sintomas de apraxia de marcha, demência e incontinência urinária. O tratamento padrão é realizado através de implantação de derivação ventricular, porém várias complicações são frequentes, como a hiperdrenagem secundária ao efeito sifão. Este estudo avaliou o resultado da válvula SPHERA® no tratamento desses pacientes em comparação com um grupo controle (PS Medical®). 30 pacientes foram consecutivamente alocados em dois grupos de 15 e seguidos por 1 ano. Pacientes com a válvula SPHERA® tiveram o mesmo grau de melhora clínica em comparação ao grupo controle, no entanto as complicações diagnósticadas e sintomatologia secundária à hiperdrenagem foi significativamente inferior no grupo da válvula SPHERA® group, sugerindo-a como uma ferramenta segura e aplicável.

normal pressure hydrocephalus - cerebrospinal fluid shunt technology - complications
hidrocefalia de pressão normal - derivações liquóricas - complicações

Authors declare that SPHERA® valves applied in the study were legally donated by HPBio company – São Paulo, in accordance with ethics committee of Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo (CAPPESQ 10992).




Publication History

Received: 08 June 2015

Accepted: 05 October 2015

Article published online:
06 September 2023

© 2015. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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