{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:29:07Z","timestamp":1789439347595,"version":"build-2803163510"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Subdural hematoma (SDH) is the most common serious adverse event in patients with shunts. Adjustable shunts are used with increasing frequency and make it possible to noninvasively treat postoperative SDH. The objective of this study was to describe the prevalence and treatment preferences of SDHs, based on fixed or adjustable shunt valves, in a national cohort of patients with shunted idiopathic normal pressure hydrocephalus (iNPH), as well as to evaluate the effect of SDH and treatment on long-term survival.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Patients with iNPH who received a CSF shunt in Sweden from 2004 to 2015 were included in a prospective quality registry (n = 1846) and followed regarding SDH, its treatment, and mortality. The treatment of SDH was categorized into surgery, opening pressure adjustments, or no treatment.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n During the study period, the proportion of adjustable shunts increased from 75% to 95%. Ten percent (n = 184) of the patients developed an SDH. In 103 patients, treatment was solely opening pressure adjustment. Surgical treatment was used in 66 cases (36%), and 15 (8%) received no treatment. In patients with fixed shunt valves, 90% (n = 17) of SDHs were treated surgically compared with 30% (n = 49) in patients with adjustable shunts (p < 0.001). There was no difference in long-term patient survival between the SDH and non-SDH groups or between different treatments.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n SDH remains a common complication after shunt surgery, but adjustable shunts reduced the need for surgical interventions. SDH and treatment did not significantly affect survival in this patient group, thus the noninvasive treatment offered by adjustable shunts considerably reduces the level of severity for this common adverse event.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2017.5.jns17481","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T09:59:31Z","timestamp":1509098371000},"page":"797-804","source":"Crossref","is-referenced-by-count":32,"title":["Subdural hematomas in 1846 patients with shunted idiopathic normal pressure hydrocephalus: treatment and long-term survival"],"prefix":"10.3171","volume":"129","author":[{"given":"Nina","family":"Sundstr\u00f6m","sequence":"first","affiliation":[{"name":"Departments of Radiation Sciences, Biomedical Engineering, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Lagebrant","sequence":"additional","affiliation":[{"name":"Pharmacology and Clinical Neuroscience, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Eklund","sequence":"additional","affiliation":[{"name":"Departments of Radiation Sciences, Biomedical Engineering, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars-Owe D.","family":"Koskinen","sequence":"additional","affiliation":[{"name":"Pharmacology and Clinical Neuroscience, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Malm","sequence":"additional","affiliation":[{"name":"Pharmacology and Clinical Neuroscience, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"490","DOI":"10.3171\/jns.1998.88.3.0490","article-title":"Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts","volume":"88","author":"Boon AJ","year":"1998","unstructured":"Boon AJ, Tans JT, Delwel EJ, Egeler-Peerdeman SM, Hanlo PW, Wurzer HA, : Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts. 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