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.
In this study we report about our experience in surgical therapy of patients with intracranial supratentorial cysts. The main interest herein lies in the difference between conventional surgery and the endoscopic approach. Since 1997 in the Unfallkrankenhaus Berlin 4 male and 4 female patients with intracranial cysts aged between 21 and 66 have been treated surgically. The intracranial endoscopy was performed in 6 patients. The initially complained, mostly unspecific, symptoms diminished post operatively and in the follow-up. As complications a transient hemiparesis and an aseptic bone necrosis have to be mentioned, the latter after use of conventional surgery. In clear diagnostic cases an operation of intracranial cysts seems appropriate. Both surgical methods, open and endoscopic approach, are appropriate. To avoid complications due to greater surgical wounds the endoscopic method should be preferred.
The diagnosis of iNPH does not by itself mean a worse prognosis, and iNPH patients with favorable preconditions may have a similar or better prognosis than patients with any other kind of hydrocephalus. The worse overall clinical results of iNPH result from late recognition and in most instances worse preconditions.
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