Prognosis
Response to surgery is variable, but a positive response is less likely in those with extensive radiologic change on neuroimaging.[19][31] Response should be evaluated by video-recording a timed walk, and by repeat testing of cognitive function. Improvement of symptoms provides a reasonable reflection of the success of surgery. Gait is usually the symptom most improved postoperatively, cognitive function somewhat less, and urinary symptoms show the least improvement.[19]
Failure to improve despite a functioning shunt may be explained by misplacement of the catheter in the brain, misdiagnosis, or the development of a complication such as subdural hematoma or infection.
Shunting is lifelong, but there is no reliable information on whether shunting improves life expectancy, and many patients eventually require shunt revision.
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