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Should a VP or LP Shunt be Used for the Treatment of Pseudotumorcerebri in Adults?

Should a VP or LP Shunt be Used for the Treatment of Pseudotumorcerebri in Adults?
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摘要 Introduction: Pseudotumorcerebri(PTC) is a condition characterized by false brain tumor symptoms, caused by high intracranial pressure (ICP). Treatment options include medication, weight loss, surgery, and shunting. Shunting, either ventriculoperitoneal (VP) or lumboperitoneal (LP), emerged as the preferred method of treatment, but there is an ongoing debate as to which technique should be prioritized. The aim of this study is to gather additional evidence to determine the optimal type of shunt for treating PTC. Materials and Methods: Ninety patients with PTC were studied at Damascus University between 2016 and 2021. The study monitored symptoms before and after treatment, with improvement related to the technique used (VP or LP shunts). Of all patients, 83 were women and 7 were men. In addition, complications were analyzed. Results: Both shunts showed similar postoperative rates of symptom improvement, but VP shunts were utilized more frequently overall in this study. Patients who received LP shunt surgery had a higher rate of postoperative complications compared to those who received VP shunt surgery, but the chi-squared analysis did not provide sufficient evidence to confirm a significant relationship between the type of surgery and the occurrence of postoperative complications. Conclusion: Despite ongoing controversy about the optimal treatment for benign intracranial hypertension (BTC), most authors approved the trend of using VP (ventriculoperitoneal) shunts, given a lower rate of complications. However, there is no statistically significant difference between outcomes of VP and LP (lumboperitoneal) shunting techniques, according to our research. Introduction: Pseudotumorcerebri(PTC) is a condition characterized by false brain tumor symptoms, caused by high intracranial pressure (ICP). Treatment options include medication, weight loss, surgery, and shunting. Shunting, either ventriculoperitoneal (VP) or lumboperitoneal (LP), emerged as the preferred method of treatment, but there is an ongoing debate as to which technique should be prioritized. The aim of this study is to gather additional evidence to determine the optimal type of shunt for treating PTC. Materials and Methods: Ninety patients with PTC were studied at Damascus University between 2016 and 2021. The study monitored symptoms before and after treatment, with improvement related to the technique used (VP or LP shunts). Of all patients, 83 were women and 7 were men. In addition, complications were analyzed. Results: Both shunts showed similar postoperative rates of symptom improvement, but VP shunts were utilized more frequently overall in this study. Patients who received LP shunt surgery had a higher rate of postoperative complications compared to those who received VP shunt surgery, but the chi-squared analysis did not provide sufficient evidence to confirm a significant relationship between the type of surgery and the occurrence of postoperative complications. Conclusion: Despite ongoing controversy about the optimal treatment for benign intracranial hypertension (BTC), most authors approved the trend of using VP (ventriculoperitoneal) shunts, given a lower rate of complications. However, there is no statistically significant difference between outcomes of VP and LP (lumboperitoneal) shunting techniques, according to our research.
作者 Hassan Kadri Raed Abouharb Rostom Mackieh Rafik Haider Tim Kadri Hassan Kadri;Raed Abouharb;Rostom Mackieh;Rafik Haider;Tim Kadri(Faculty of Medicine, Department of Neurosurgery, Damascus University, Damascus, Syria;Faculty of Medicine, Department of Internal Medicine, Damascus University, Damascus, Syria;Department of Statistics, MSRC, Damascus, Syria)
出处 《Open Journal of Modern Neurosurgery》 2023年第4期149-155,共7页 现代神经外科学进展(英文)
关键词 Pseudotumorcerebri (PTC) Benign Intracranial Hypertension (BTC) Ventriculoperitoneal (VP) Shunt Lumboperitoneal (LP) Shunt Cerebrospinal Fluid (CSF) Pseudotumorcerebri (PTC) Benign Intracranial Hypertension (BTC) Ventriculoperitoneal (VP) Shunt Lumboperitoneal (LP) Shunt Cerebrospinal Fluid (CSF)
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