[原著]正常圧水頭症例の手術効果について

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Eleven cases were diagnosed as Normal Pressure Hydrocephalus (NPH) and performed shunt therapy in our hospital over a four-year period. They were analyzed on factors considered to exert influence upon the shunt effect. Many successful cases of the therapy were found among patients not more than 60 years old, although the therapy displayed a remarkable effect on a 77 year-old patient. Eight patients had etiology of NPH. Of then, six were affected with subarachnoid hemorrhage. And other three patients had on etiology. There was no relationship between the shunt effect and the type of etiology of NPH. The time interval between the onset of symptoms of NPH and the performance of shunt therapy was two months on the average in the effective cases and 7.5 months on the average in the ineffective cases. Therefore, the shorter this interval, the more satisfactory the results of this therapy tended to be. There was no relationship between clincal symptoms and the effect of operation. It was necessary, however, to be very careful about the apphcation of shunt therapy to patients with mental symptoms alone. CT scanning was most important as an auxiliary test. Even in patients with dilated ventricle and periventricular low density, shunt operation was ineffective when the patients had brain atrophy and injuries of the brain. Postoperative complication was seen in two patients. It was an injury of blood vessels induced at the time of insertion of ventricular tube. The injury led subdural, intracerebral and intraventricular hemorrhage. In conclusion, shunt therapy should be indicated after careful selection of a causative disease, the minute observation of clinical symptoms and the findings of auxiliary tests, especially CT scanning. It seems necessary to evade an insignificant operation of shunt therapy.
琉球大学保健学部,College of Health Sciences, University of the Ryukyusの論文

著者

高木繁幸
琉球大学医学部附属病院脳神経外科

[原著]正常圧水頭症例の手術効果について

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