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doctoral thesis
Liječenje idiopatskog normotenzivnog hidrocefalusa
2020. urn:nbn:hr:171:891976
Tudor, Katarina Ivana
University of Split
School of Medicine

Cite this document

Tudor, K. I. (2020). Liječenje idiopatskog normotenzivnog hidrocefalusa (Doctoral thesis). Split: University of Split, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:171:891976

Tudor, Katarina Ivana. "Liječenje idiopatskog normotenzivnog hidrocefalusa." Doctoral thesis, University of Split, School of Medicine, 2020. https://urn.nsk.hr/urn:nbn:hr:171:891976

Tudor, Katarina Ivana. "Liječenje idiopatskog normotenzivnog hidrocefalusa." Doctoral thesis, University of Split, School of Medicine, 2020. https://urn.nsk.hr/urn:nbn:hr:171:891976

Tudor, K. I. (2020). 'Liječenje idiopatskog normotenzivnog hidrocefalusa', Doctoral thesis, University of Split, School of Medicine, accessed 23 April 2024, https://urn.nsk.hr/urn:nbn:hr:171:891976

Tudor KI. Liječenje idiopatskog normotenzivnog hidrocefalusa [Doctoral thesis]. Split: University of Split, School of Medicine; 2020 [cited 2024 April 23] Available at: https://urn.nsk.hr/urn:nbn:hr:171:891976

K. I. Tudor, "Liječenje idiopatskog normotenzivnog hidrocefalusa", Doctoral thesis, University of Split, School of Medicine, Split, 2020. Available at: https://urn.nsk.hr/urn:nbn:hr:171:891976

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Metadata
TitleLiječenje idiopatskog normotenzivnog hidrocefalusa
Title (english)Treatment of idiopathic normotensive hydrocephalus
AuthorKatarina Ivana Tudor https://orcid.org/0000-0002-5293-1646
MentorFran Borovečki (mentor)
Committee memberOzren Polašek (predsjednik povjerenstva)
Committee memberMarina Titlić (član povjerenstva)
Committee memberIvan Škoro (član povjerenstva)
GranterUniversity of Split
School of Medicine
Split
Defense date and country2020, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Neurology
Universal decimal classification
(UDC)		616 - Pathology. Clinical medicine
Abstract
Normotenzivni je hidrocefalus (NTH) je tip komunicirajućeg hidrocefalusa s urednim vrijednostima intraventrikularnog tlaka, koji je klinički karakteriziran trijasom: ataksije, demencije i inkontinencije urina. Može ga se liječiti konzervativnim putem ili neurokirurški umetanjem ventrikuloperitonejske (VP) ili (kako se prije više radilo) ventrikuloatrijske (VA) drenaže. Međutim, poznato je da bitan broj bolesnika ne odgovori na navedeno neurokirurško liječenje, dok je stopa komplikacija visoka te su često potrebne revizije. Endoskopska ventrikulostomija treće komore (ETV) je alternativna neurokirurška metoda. U prvom publiciranom istraživanju koje se bavi ovom tematikom, Cochrane preglednom članku, jedina utvrđena randomizirana kontrolirana studija primjene ETV-e uspoređuje tu metodu liječenja sa metodom koja danas ne predstavlja standard u liječenju (VP drenaža korištenjem neprogramabilne valvule). Medicinski dokazi iz ove studije nisu uvjerljivi i slabe su kvalitete (procjenom korištenjem GRADE ljestvice) te je zaključeno da su potrebna dodatna robustnija istraživanja. U sljedećem istraživanju koje je provedeno u našoj ustanovi, liječenje iNTH VP drenažom pokazala je značajno poboljšanje. Potrebna su dodatna istraživanja za procjenu uspješnosti ETV u liječenju iNTH.
Abstract (english)
Idiopathic normal pressure hydrocephalus (iNPH) is a type of communicating hydrocephalus also known as non-obstructive hydrocephalus, characterised clinically by gait disturbance, cognitive dysfunction, and urinary incontinence (known as the Hakim-Adams triad). It may be managed conservatively or treated surgically by inserting a ventriculoperitoneal (VP) or ventriculoatrial (VA) shunt. However, a substantial number of patients do not respond well to surgical treatment, complication rates are high and there is often a need for further surgery. Endoscopic third ventriculostomy (ETV) is an alternative surgical intervention. In the first published paper on this topic, the Cochrane review, only one randomized controlled trial (RCT) of ETV for iNPH was established that compares it to an intervention which is not a standard practice today (VP shunting using a non-programmable valve). The evidence from this study was found to be inconclusive and of very low quality (using GRADE), and we concluded that there is a need for more robust research. In the subsequent study that was conducted in our institution, treatment of iNPH with VP shunt showed significant improvement. A properly designed study is required to address the efficacy of ETV in the treatment of iNPH.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:171:891976
Study programmeTitle: Evidence-Based Clinical Medicine
Study programme type: university
Study level: postgraduate
Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-05-05 07:04:26