Predictors of shunt response in iNPH: differentiating responders, early and late non-responders, and the role of valve adjustments
Our study underscores that valve pressure adjustments in early non-responders, who likely never benefit from shunt surgery, are not effective, and highlights the emergence of a late non-responder phenotype, where symptom deterioration becomes evident 6 months post-shunting. Our findings outline the need to explore alternative treatment strategies for managing symptoms in iNPH non-responders, as well as prolonged follow-up regimens to monitor late non-responders.
Authors
- Daniele Ramsay (ORCID: https://orcid.org/0000-0001-5585-1118)
- Angelika Gutenberg
- Andreas Krämer (ORCID: https://orcid.org/0000-0002-2586-5508)
- Stefanie Kalb
- Santhosh G. Thavarajasingam (ORCID: https://orcid.org/0000-0002-9274-0350)
- Ahkash Thavarajasingam
- Dragan Janković (ORCID: https://orcid.org/0000-0003-3451-9751)
- Darius Kalasauskas (ORCID: https://orcid.org/0000-0001-6174-3949)
- Malte Ottenhausen (ORCID: https://orcid.org/0000-0003-0797-1101)
- Florian Ringel (ORCID: https://orcid.org/0000-0003-3132-7543)
- Ahmed Salih (ORCID: https://orcid.org/0000-0002-6470-3325)
- Mahmoud El‐Khatib
Institutions
- Johannes Gutenberg University Mainz (DE)
- LMU Klinikum (DE)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Imperial College London (GB)
- Ludwig-Maximilians-Universität München (DE)
Publication Details
- Journal
- Acta Neurochirurgica
- Published
- 2025-09-13
- DOI
- https://doi.org/10.1007/s00701-025-06663-9
- Primary Topic
- Cerebrospinal fluid and hydrocephalus
- Type
- article
- Field-Weighted Citation Impact
- 0.00