{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:29:10Z","timestamp":1789439350440,"version":"build-2803163510"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T00:00:00Z","timestamp":1535673600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Ventriculoperitoneal shunt (VP-shunt) is the standard of treatment for idiopathic normal pressure hydrocephalus (iNPH). However, a thorough investigation of VP-shunt complications in this population is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To present the analysis and the rates of complications progressively occurring during the first year after shunt surgery in the patients with iNPH included in the European multicenter (EU-iNPH) study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients (n\u00a0=\u00a0142) were prospectively included in the EU-iNPH study by 13 institutions. All patients received a programmable VP-shunt. One hundred fifteen patients completed the 12-mo follow-up. Reexaminations were performed 1, 3, and 12 mo after surgery. Data regarding symptomatic over- or underdrainage, infections, malposition, subdural collections, and shunt surgery were collected and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Thirty patients (26%) experienced symptoms due to shunt underdrainage. Symptomatic overdrainage was reported in 10 (9%). Shunt adjustments were made in 43 (37%). Shunt malposition was recognized as the primary cause of shunt malfunction in 8 (7%), while only 1 infection (0.9%) occurred. Subdural hematoma was diagnosed in 7 (6%) and was treated by increasing the opening pressure of the valve in 5 patients. Hygroma was diagnosed in 10 (9%), requiring surgery in 1 patient. Overall, 17 patients (15%) underwent 19 shunt surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The advances in valve technology, a careful opening pressure setting, and rigorous follow-up allow a significant reduction of complications, which can be usually managed nonsurgically within the first 3 to 6 mo.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy232","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T22:15:14Z","timestamp":1535667314000},"page":"97-102","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":70,"title":["Ventriculoperitoneal Shunt Complications in the European Idiopathic Normal Pressure Hydrocephalus Multicenter Study"],"prefix":"10.1227","volume":"17","author":[{"given":"Alberto","family":"Feletti","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Unit of Neurosurgery, NOCSAE Modena Hospital, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"d\u2019Avella","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Academic Neurosurgery, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Wikkels\u00f8","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Klinge","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Hellstr\u00f6m","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos","family":"Tans","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Centre Haaglanden, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Saarland University, Homburg-Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Meier","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery. Akademisches Lehrkrankenhaus der Freien Universit\u00e4t Berlin. Krankenhaus Berlin-Marzahn, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Lemcke","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery. Akademisches Lehrkrankenhaus der Freien Universit\u00e4t Berlin. Krankenhaus Berlin-Marzahn, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Patern\u00f2","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, International Neuroscience Institute Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lennart","family":"Stieglitz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, International Neuroscience Institute Hannover, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Sames","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Masaryk Hospital, Usti nad Labem, The Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel","family":"Saur","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Masaryk Hospital, Usti nad Labem, The Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariann","family":"Kord\u00e1s","sequence":"additional","affiliation":[{"name":"National Institute of Neurosurgery, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusan","family":"Vitanovic","sequence":"additional","affiliation":[{"name":"National Institute of Neurosurgery, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreu","family":"Gabarr\u00f3s","sequence":"additional","affiliation":[{"name":"Hospital Universitari de Bellvitge, Neurosurgery Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feixa","family":"Llarga","sequence":"additional","affiliation":[{"name":"L\u2019Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Triffaux","sequence":"additional","affiliation":[{"name":"Service de Neurochirurgie. Clinique au Jardin Botanique 32, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Tyberghien","sequence":"additional","affiliation":[{"name":"Service de Neurochirurgie. Clinique au Jardin Botanique 32, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Juhler","sequence":"additional","affiliation":[{"name":"Neurokirurgisk Klinik NK 2092, Memory Disorders Research Unit, The Neuroscience Center, N6702, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stehen","family":"Hasselbalch","sequence":"additional","affiliation":[{"name":"Neurokirurgisk Klinik NK 2092, Memory Disorders Research Unit, The Neuroscience Center, N6702, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Cesarini","sequence":"additional","affiliation":[{"name":"Neurologiska kliniken, Akademiska Sjukhuset, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Laurell","sequence":"additional","affiliation":[{"name":"Neurologiska kliniken, Akademiska Sjukhuset, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,7]]},"reference":[{"issue":"3","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1590\/1806-9282.61.03.258","article-title":"Evidences in the treatment of idiopathic normal pressure hydrocephalus","volume":"61","author":"de Oliveira","year":"2015","journal-title":"Rev Assoc Med Bras"},{"issue":"2","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.clineuro.2011.09.014","article-title":"The neuropsychology of iNPH: findings and evaluation of tests in the European multicentre study","volume":"114","author":"Hellstr\u00f6m","year":"2012","journal-title":"Clin Neurol Neurosurg"},{"issue":"3","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1600-0404.2012.01676.x","article-title":"One-year outcome in the European multicentre study on iNPH","volume":"126","author":"Klinge","year":"2012","journal-title":"Acta Neurol Scand"},{"issue":"5","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1136\/jnnp-2012-303314","article-title":"The European iNPH Multicentre Study on the predictive values of resistance to CSF outflow and the CSF Tap Test in patients with idiopathic normal pressure hydrocephalus","volume":"84","author":"Wikkels\u00f8","year":"2013","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/978-3-7091-0956-4_49","article-title":"Idiopathic normal pressure hydrocephalus: results of a prospective cohort of 236 shunted patients","volume":"114","author":"Poca","year":"2012","journal-title":"Acta Neurochir Suppl"},{"issue":"5","key":"bib6-20240909","first-page":"1166","article-title":"Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome","volume":"49","author":"Hebb","year":"2001","journal-title":"Neurosurgery"},{"issue":"6","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1097\/00006123-200212000-00009","article-title":"Adjustable valves in normal-pressure hydrocephalus: a retrospective study of 218 patients","volume":"51","author":"Zemack","year":"2002","journal-title":"Neurosurgery"},{"issue":"5","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"855","DOI":"10.3171\/jns.2004.100.5.0855","article-title":"Is the placement of shunts in patients with idiopathic normal pressure hydrocephalus worth the risk? 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