{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:29:16Z","timestamp":1789439356882,"version":"build-2803163510"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T00:00:00Z","timestamp":1736294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003748","name":"Svenska S\u00e4llskapet f\u00f6r Medicinsk Forskning","doi-asserted-by":"publisher","award":["SG-22-0192-H-01"],"award-info":[{"award-number":["SG-22-0192-H-01"]}],"id":[{"id":"10.13039\/501100003748","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007051","name":"Uppsala University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The follow-up routine for patients with idiopathic normal pressure hydrocephalus (iNPH) after shunt surgery differs across medical centers. Shunt surgery is not without risks, with complications emerging at various times after the procedure. The aim was to explore the timing and methods of detecting complications following ventriculoperitoneal shunt surgery for iNPH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective study examined patients who underwent shunt surgery for iNPH at Uppsala University Hospital between 2011 and 2018. The cohort comprised 491 patients. Postoperative complications within the first 12 months were recorded from medical records. Complications were classified by type, and the method or event that first indicated the complication was documented.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of the 491 patients, 102 (20.8%) experienced complications during the one-year follow-up period, with a shunt revision rate of 15.5% (76 patients requiring reoperation). Subdural hematomas\/hygromas were the most common complications, with 27 cases; only three required surgical intervention. Most complications were identified through additional appointments triggered by patient-reported symptoms (31.4%), while the planned follow-up routine with CT scans and planned follow-up visits together accounted for 56% of the detections. The 3-month and 12-month follow-up visits detected similar proportions of complications (12.7% and 11.8%, respectively).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The majority of the complications were detected at a planned visit or investigation. Given the cognitive impairments in iNPH patients and that signs of shunt dysfunction can be subtle, a structured follow-up routine is important for timely detection of complications. The findings suggest that both CT scans and planned follow-up visits are critical components of effective postoperative monitoring.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-024-06415-1","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T21:02:41Z","timestamp":1736370161000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["When and how are complications suspected after shunt surgery in patients with normal pressure hydrocephalus?"],"prefix":"10.1007","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-2949","authenticated-orcid":false,"given":"Johan","family":"Virhammar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Fasth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Vedung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,8]]},"reference":[{"key":"6415_CR1","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.jns.2018.05.022","volume":"391","author":"S Agerskov","year":"2018","unstructured":"Agerskov S, Hellstrom P, Andren K, Kollen L, Wikkelso C, Tullberg M (2018) The phenotype of idiopathic normal pressure hydrocephalus-a single center study of 429 patients. J Neurol Sci 391:54\u201360. https:\/\/doi.org\/10.1016\/j.jns.2018.05.022","journal-title":"J Neurol Sci"},{"key":"6415_CR2","doi-asserted-by":"publisher","first-page":"e208037","DOI":"10.1212\/wnl.0000000000208037","volume":"102","author":"C Constantinescu","year":"2024","unstructured":"Constantinescu C, Wikkels\u00f8 C, Westman E, Ziegelitz D, Jaraj D, Ryd\u00e9n L, Skoog I, Tullberg M (2024) Prevalence of possible idiopathic normal pressure Hydrocephalus in Sweden: a Population-based MRI study in 791 70-Year-old participants. Neurology 102:e208037. https:\/\/doi.org\/10.1212\/wnl.0000000000208037","journal-title":"Neurology"},{"key":"6415_CR3","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.1007\/s13760-020-01538-5","volume":"121","author":"MF de Oliveira","year":"2021","unstructured":"de Oliveira MF, Sorte AAB Jr, Emerenciano DL, Rotta JM, Mendes GAS, Pinto FCG (2021) Long term follow-up of shunted idiopathic normal pressure hydrocephalus patients: a single center experience. Acta Neurol Belg 121:1799\u20131806. https:\/\/doi.org\/10.1007\/s13760-020-01538-5","journal-title":"Acta Neurol Belg"},{"key":"6415_CR4","doi-asserted-by":"publisher","unstructured":"Giordan E, Palandri G, Lanzino G, Murad MH, Elder BD (2018) Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. J Neurosurg 1\u201313. https:\/\/doi.org\/10.3171\/2018.5.Jns1875","DOI":"10.3171\/2018.5.Jns1875"},{"key":"6415_CR5","doi-asserted-by":"publisher","first-page":"e458","DOI":"10.1016\/j.wneu.2019.05.183","volume":"129","author":"G Grasso","year":"2019","unstructured":"Grasso G, Torregrossa F, Leone L, Frisella A, Landi A (2019) Long-term efficacy of Shunt Therapy in Idiopathic Normal pressure Hydrocephalus. World Neurosurg 129:e458\u2013e463. https:\/\/doi.org\/10.1016\/j.wneu.2019.05.183","journal-title":"World Neurosurg"},{"key":"6415_CR6","doi-asserted-by":"publisher","first-page":"e0198752","DOI":"10.1371\/journal.pone.0198752","volume":"13","author":"M Kamenova","year":"2018","unstructured":"Kamenova M, Rychen J, Guzman R, Mariani L, Soleman J (2018) Yield of early postoperative computed tomography after frontal ventriculoperitoneal shunt placement. PLoS ONE 13:e0198752. https:\/\/doi.org\/10.1371\/journal.pone.0198752","journal-title":"PLoS ONE"},{"key":"6415_CR7","doi-asserted-by":"publisher","first-page":"S40","DOI":"10.1227\/01.NEU.0000168187.01077.2F","volume":"57","author":"P Klinge","year":"2005","unstructured":"Klinge P, Marmarou A, Bergsneider M, Relkin N, Black PM (2005) Outcome of shunting in idiopathic normal-pressure hydrocephalus and the value of outcome assessment in shunted patients. Neurosurgery 57:S40-52 (discussion ii-v. doi:00006123-200509001-00012 [pii])","journal-title":"Neurosurgery"},{"key":"6415_CR8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1080\/02688697.2016.1229749","volume":"31","author":"N Sundstrom","year":"2017","unstructured":"Sundstrom N, Malm J, Laurell K, Lundin F, Kahlon B, Cesarini KG, Leijon G, Wikkelso C (2017) Incidence and outcome of surgery for adult hydrocephalus patients in Sweden. 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Acta Neurochir (Wien) 155:1977\u20131980. https:\/\/doi.org\/10.1007\/s00701-013-1835-5","journal-title":"Acta Neurochir (Wien)"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-024-06415-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-024-06415-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-024-06415-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T22:03:16Z","timestamp":1736373796000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-024-06415-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,8]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["6415"],"URL":"https:\/\/doi.org\/10.1007\/s00701-024-06415-1","relation":{},"ISSN":["0942-0940"],"issn-type":[{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,8]]},"assertion":[{"value":"20 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Swedish Ethical Review Authority approved the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6"}}