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Normal Pressure Hydrocephalus

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2. Normal pressure hydrocephalus

Normal pressure hydrocephalus Normal pressure hydrocephalus - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Normal pressure hydrocephalus Last reviewed: February 2019 Last updated: February 2018 Summary Characterised by the clinical features of hydrocephalus (i.e., levodopa-unresponsive gait apraxia with or without cognitive impairment or urinary symptoms), but without significantly raised cerebrospinal fluid (...) pressure. Cannot be reliably diagnosed using neuroimaging alone. Differential diagnosis includes other causes of parkinsonism and common dementia disorders. Responds to ventriculoperitoneal shunting if treated early enough. Selection of patients for surgery is challenging as many are considered a high surgical risk. Definition Normal pressure hydrocephalus (NPH), also known as idiopathic normal pressure hydrocephalus (INPH), is a condition characterised by the clinical features of hydrocephalus (i.e

2018 BMJ Best Practice

3. Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis

Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis OBJECTIVEDifferent CSF diversion procedures (ventriculoperitoneal, ventriculoatrial, and lumboperitoneal shunting) have been utilized for the treatment of idiopathic normal pressure hydrocephalus. More recently, endoscopic third ventriculostomy has been suggested as a reasonable alternative in some studies. The purpose of this study was to perform (...) searched for studies involving patients with idiopathic ventriculomegaly, no secondary cause of hydrocephalus, opening pressure < 25 mm Hg on high-volume tap or drainage trial, and age > 60 years. Outcomes included the proportion of patients who showed improvement in gait, cognition, and bladder function. Adverse events considered in the analysis included postoperative ischemic/hemorrhagic complications, subdural fluid collections, seizures, need for revision surgery, and infection.RESULTSA total of 33

2019 EvidenceUpdates

4. Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. (PubMed)

Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. Idiopathic normal pressure hydrocephalus (iNPH) causing gait impairment, dementia and urinary incontinence among the elderly, is probably under-diagnosed and under-treated. Despite being known since the 1960s, there is still a lack of prospective, population-based studies on the prevalence of iNPH. Such studies are warranted to minimize selection bias and estimate the true prevalence (...) of the disease.The prevalence of iNPH was determined in a randomly selected sample of residents, aged 65 years and older, in the Swedish county of Jämtland. Out of 1,000 individuals invited to participate, 673 (67.3%) completed a questionnaire with seven questions on iNPH symptoms. A subgroup, with and without self-reported symptoms, participated in clinical and radiological evaluations and were diagnosed according to international guidelines. Measurement of cerebrospinal fluid opening pressure was not performed

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2019 PLoS ONE

5. Endoscopic third ventriculostomy (ETV) for idiopathic normal pressure hydrocephalus (iNPH). (PubMed)

Endoscopic third ventriculostomy (ETV) for idiopathic normal pressure hydrocephalus (iNPH). Idiopathic normal pressure hydrocephalus (iNPH) is a type of communicating hydrocephalus also known as non-obstructive hydrocephalus. This type of hydrocephalus is caused by impaired cerebrospinal fluid reabsorption without any obstruction in the ventricular system and is associated with normal cerebrospinal fluid pressure. It is characterised clinically by gait disturbance, cognitive dysfunction (...) ) of ETV treatment of iNPH. Patients had to have at least two symptoms of the Hakim-Adams triad. Exclusion criteria were obstructive causes of hydrocephalus, other significant intracranial pathology and other confirmed causes of dementia. The eligible comparators were conservative treatment or shunting using VP and VA shunts.Two review authors independently screened search results, selected eligible studies, assessed risk of bias and extracted data. We contacted trial authors for additional data.Only

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2015 Cochrane

6. Flow-regulated versus differential pressure-regulated shunt valves for adult patients with normal pressure hydrocephalus. (PubMed)

Flow-regulated versus differential pressure-regulated shunt valves for adult patients with normal pressure hydrocephalus. Since 1965 many ventriculo-peritoneal shunt systems have been inserted worldwide to treat hydrocephalus. The most frequent indication in adults is normal pressure hydrocephalus (NPH), a condition that can be difficult to diagnose precisely. Surgical intervention with flow-regulated and differential pressure-regulated ventriculo-peritoneal shunts remains controversial (...) ) (EBSCOhost); PsycINFO (from 1806) (Ovid SP); LILACS (from 1982 ) (BIREME); ClinicalTrials.gov; Umin Japan Trial Register; WHO portal;The Cochrane Library's Central Register of Controlled trials (CENTRAL); ISI Web of Knowledge Conference Proceedings; Index to Theses; and Australasian Digital Theses were searched until May 16, 2012.The search terms used were NPH, "normal pressure hydrocephalus," iNPH, idiopathic normal pressure hydrocephalus, sNPH, and "secondary normal pressure hydrocephalus."We planned

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2013 Cochrane

7. Non-invasive Estimation of the Intracranial Pressure Waveform from the Central Arterial Blood Pressure Waveform in Idiopathic Normal Pressure Hydrocephalus Patients (PubMed)

Non-invasive Estimation of the Intracranial Pressure Waveform from the Central Arterial Blood Pressure Waveform in Idiopathic Normal Pressure Hydrocephalus Patients This study explored the hypothesis that the central aortic blood pressure (BP) waveform may be used for non-invasive estimation of the intracranial pressure (ICP) waveform. Simultaneous invasive ICP and radial artery BP waveforms were measured in 29 individuals with idiopathic normal pressure hydrocephalus (iNPH). The central aortic

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2018 Scientific reports

8. The Computerized General Neuropsychological INPH Test revealed improvement in idiopathic normal pressure hydrocephalus after shunt surgery. (PubMed)

The Computerized General Neuropsychological INPH Test revealed improvement in idiopathic normal pressure hydrocephalus after shunt surgery. OBJECTIVEThe Computerized General Neuropsychological INPH Test (CoGNIT) provides the clinician and the researcher with standardized and accessible cognitive assessments in patients with idiopathic normal pressure hydrocephalus (INPH). CoGNIT includes tests of memory, executive functions, attention, manual dexterity, and psychomotor speed. Investigations

2019 Journal of Neurosurgery

9. Repeated Cerebrospinal Fluid Removal Procedure in Older Patients With Idiopathic Normal Pressure Hydrocephalus Ineligible for Surgical Treatment. (PubMed)

Repeated Cerebrospinal Fluid Removal Procedure in Older Patients With Idiopathic Normal Pressure Hydrocephalus Ineligible for Surgical Treatment. To evaluate the effects of repeated cerebrospinal fluid (CSF) tap procedures in idiopathic normal pressure hydrocephalus (iNPH) patients ineligible for surgical treatment.Prospective, monocentric, pilot study.University hospital.Thirty-nine patients aged 75 years and older, ineligible for shunting surgical intervention.Repeated CSF taps.All patients

2019 Journal of the American Medical Directors Association

10. Lumbar drain trial outcomes of normal pressure hydrocephalus: a single-center experience of 254 patients. (PubMed)

Lumbar drain trial outcomes of normal pressure hydrocephalus: a single-center experience of 254 patients. OBJECTIVEA short-term lumbar drain (LD) trial is commonly used to assess the response of normal pressure hydrocephalus (NPH) patients to CSF diversion. However, it remains unknown whether the predictors of passing an LD trial match the predictors of improvement after ventriculoperitoneal shunting. The aim of this study was to examine outcomes, complication rates, and associations between

2019 Journal of Neurosurgery

11. Prevalence of C9ORF72 Expansion in a Large Series of Patients with Idiopathic Normal-Pressure Hydrocephalus. (PubMed)

Prevalence of C9ORF72 Expansion in a Large Series of Patients with Idiopathic Normal-Pressure Hydrocephalus. The C9ORF72 expansion is known to cause frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS). We aim to identify the prevalence of the C9ORF72 expansion in idiopathic normal pressure hydrocephalus (iNPH).We analysed the C9ORF72 expansion in a large cohort of patients with possible iNPH (n = 487) and cognitively intact elderly controls (n = 432; age > 65 years

2019 Dementia and Geriatric Cognitive Disorders

12. Nonsense mutation in <i>CFAP43</i> causes normal-pressure hydrocephalus with ciliary abnormalities. (PubMed)

Nonsense mutation in CFAP43 causes normal-pressure hydrocephalus with ciliary abnormalities. To identify genes related to normal-pressure hydrocephalus (NPH) in one Japanese family with several members with NPH.We performed whole-exome sequencing (WES) on a Japanese family with multiple individuals with NPH and identified a candidate gene. Then we generated knockout mouse using CRISPR/Cas9 to confirm the effect of the candidate gene on the pathogenesis of hydrocephalus.In WES, we (...) identified a loss-of-function variant in CFAP43 that segregated with the disease. CFAP43 encoding cilia- and flagella-associated protein is preferentially expressed in the testis. Recent studies have revealed that mutations in this gene cause male infertility owing to morphologic abnormalities of sperm flagella. We knocked out mouse ortholog Cfap43 using CRISPR/Cas9 technology, resulting in Cfap43-deficient mice that exhibited a hydrocephalus phenotype with morphologic abnormality of motile cilia.Our

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2019 Neurology

13. Clinical outcomes of normal pressure hydrocephalus in 116 patients: objective versus subjective assessment. (PubMed)

Clinical outcomes of normal pressure hydrocephalus in 116 patients: objective versus subjective assessment. OBJECTIVEObjective assessment tests are commonly used to predict the response to ventriculoperitoneal (VP) shunting in patients with normal pressure hydrocephalus (NPH). Whether subjective reports of improvement after a lumbar drain (LD) trial can predict response to VP shunting remains controversial. The goal in this study was to compare clinical characteristics, complication rates

2019 Journal of Neurosurgery

14. Effect of fixed-setting versus programmable valve on incidence of shunt revision after ventricular shunting for idiopathic normal pressure hydrocephalus. (PubMed)

Effect of fixed-setting versus programmable valve on incidence of shunt revision after ventricular shunting for idiopathic normal pressure hydrocephalus. Although ventricular shunting is an effective therapy for idiopathic normal pressure hydrocephalus (iNPH), the effect of shunt valve type on the incidence of revision surgery is not well defined. To address this issue, shunt revision rates between patients with iNPH receiving a fixed-setting valve (FSV) versus a programmable valve (PV) were

2019 Journal of Neurosurgery

15. Normal Pressure Hydrocephalus Is Associated With Increased Risks of Postoperative Complications Following Total Knee and Total Hip Arthroplasty. (PubMed)

Normal Pressure Hydrocephalus Is Associated With Increased Risks of Postoperative Complications Following Total Knee and Total Hip Arthroplasty. Normal pressure hydrocephalus (NPH) has not been studied as a potential risk factor for postoperative complications after primary total knee (TKA) and total hip arthroplasty (THA).Nearly 2000 patients with a diagnosis of NPH who underwent TKA or THA from 2005 to 2014 were identified in a national insurance database and compared to 10:1 matched controls

2019 Journal of Arthroplasty

16. Spinal paraganglioma presenting as normal pressure hydrocephalus: a rare occurrence. (PubMed)

Spinal paraganglioma presenting as normal pressure hydrocephalus: a rare occurrence. Objective: We report a 63 years old female who presented with confusion, urinary retention and gait disturbances. Method: CT head shows communicating hydrocephalus. Spinal MRI demonstrated an L5- S1 intradural lesion. Result: Histopathology proved it to be paraganglioma. Postoperative CT head showed reduction in size of ventricles. Association between spinal tumors and hydrocephalus is known but occurs (...) infrequently. Conclusion: The presence of an intraspinal tumor must be kept in mind as a possible cause of the hydrocephalus.

2019 British Journal of Neurosurgery

17. Delayed clearance of cerebrospinal fluid tracer from choroid plexus in idiopathic normal pressure hydrocephalus. (PubMed)

Delayed clearance of cerebrospinal fluid tracer from choroid plexus in idiopathic normal pressure hydrocephalus. Impaired clearance of amyloid-β from choroid plexus is one proposed mechanism behind amyloid deposition in Alzheimer's disease. The present study examined whether clearance from choroid plexus of a cerebrospinal fluid tracer, serving as a surrogate marker of a metabolic waste product, is altered in idiopathic normal pressure hydrocephalus (iNPH), one sub-type of dementia (...) . In a prospective observational study of close to healthy individuals (reference cohort; REF) and individuals with iNPH, we performed standardized T1-weighted magnetic resonance imaging scans before and through 24 h after intrathecal administration of a cerebrospinal fluid tracer (the magnetic resonance imaging contrast agent gadobutrol). Changes in normalized T1 signal within the choroid plexus and cerebrospinal fluid of lateral ventricles were quantified using FreeSurfer. The normalized T1 signal increased

2019 Journal of Cerebral Blood Flow and Metabolism

18. Utility of MRI-based disproportionately enlarged subarachnoid space hydrocephalus scoring for predicting prognosis after surgery for idiopathic normal pressure hydrocephalus: clinical research. (PubMed)

Utility of MRI-based disproportionately enlarged subarachnoid space hydrocephalus scoring for predicting prognosis after surgery for idiopathic normal pressure hydrocephalus: clinical research. OBJECTIVE The presence of disproportionately enlarged subarachnoid space hydrocephalus (DESH) on brain imaging is a recognized finding of idiopathic normal pressure hydrocephalus (iNPH), but the features of DESH can vary across patients. The aim of this study was to evaluate the utility of MRI-based DESH

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2017 Journal of Neurosurgery

19. Diffusion tensor imaging profiles reveal specific neural tract distortion in normal pressure hydrocephalus. (PubMed)

Diffusion tensor imaging profiles reveal specific neural tract distortion in normal pressure hydrocephalus. The pathogenesis of normal pressure hydrocephalus (NPH) remains unclear which limits both early diagnosis and prognostication. The responsiveness to intervention of differing, complex and concurrent injury patterns on imaging have not been well-characterized. We used diffusion tensor imaging (DTI) to explore the topography and reversibility of white matter injury in NPH pre- and early

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2017 PLoS ONE

20. Alzheimer's disease pathology and shunt surgery outcome in normal pressure hydrocephalus. (PubMed)

Alzheimer's disease pathology and shunt surgery outcome in normal pressure hydrocephalus. We aimed to determine whether presence of AD neuropathology predicted cognitive, gait and balance measures in patients with idiopathic normal pressure hydrocephalus (iNPH) after shunt surgery. This is a prospective study of gait and balance measured by Timed Up and Go (TUG) and Tinetti tests, and cognitive function measured by Mini Mental Status Exam (MMSE), before and after shunt surgery in participants

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2017 PLoS ONE

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