• World Neurosurg · Oct 2024

    Changes in callosal angle and Evans index after shunt surgery in patients with idiopathic normal pressure hydrocephalus.

    • Casimiro ReisRodolfoRDepartment of Neurosurgery, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil. Electronic address: rodolfocr84@yahoo.com.br., Harumi Gobbato YamashitaRenataRDepartment of Neurosurgery, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Fontoura SollaDavi JorgeDJDepartment of Neurosurgery, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Fajardo RaminLaísLNeuroradiology Section, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Tomás de Andrade Lourenção Freddi, Jacobsen TeixeiraManoelMDepartment of Neurosurgery, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., and Campos Gomes PintoFernandoFDepartment of Neurosurgery, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil..
    • Department of Neurosurgery, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil. Electronic address: rodolfocr84@yahoo.com.br.
    • World Neurosurg. 2024 Oct 1; 190: e617e621e617-e621.

    ObjectiveIdiopathic normal pressure hydrocephalus (iNPH) is a disease characterized by gait disturbance, cognitive impairment, and urinary incontinence. For those patients who do not respond to shunt surgery, it lacks objective radiologic findings for the diagnosis of shunt malfunction. Here we aimed to evaluate whether the Evans index and callosal angle change during a prospective long-term follow-up of patients with iNPH submitted to shunt surgery.MethodsClinical (NPH Japanese Scale) and radiologic (Evans index and callosal angle) data were collected pre- and postoperatively (3, 6, 12 and months) in 19 patients with iNPH. Imaging tests were evaluated by the same neuroradiologist during the follow-up.ResultsPatients had lower scores on the NPH Japanese Scale over time (P < 0.001). There was no significant difference among Evans index values during the follow-up (P = 0.24). Preoperative average callosal angle was 72 ± 15, which increased to 91 ± 18 in 6 months (P = 0.003).ConclusionsIn this sample, patients with iNPH submitted to a programmable valve shunt had an increase in callosal angle concomitant to neurologic improvement. The Evans index did not change during follow-up.Copyright © 2024 Elsevier Inc. All rights reserved.

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