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Normal Pressure Hydrocephalus

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101. One-year outcome in patients with idiopathic normal-pressure hydrocephalus: comparison of lumboperitoneal shunt to ventriculoperitoneal shunt. Full Text available with Trip Pro

One-year outcome in patients with idiopathic normal-pressure hydrocephalus: comparison of lumboperitoneal shunt to ventriculoperitoneal shunt. OBJECTIVE Idiopathic normal pressure hydrocephalus (iNPH) is treated with cerebrospinal fluid shunting, and implantation of a ventriculoperitoneal shunt (VPS) is the current standard treatment. The objective of this study was to compare the efficacy and safety of VPSs and lumboperitoneal shunts (LPSs) for patients with iNPH. METHODS The authors conducted

2016 Journal of Neurosurgery

102. Idiopathic normal pressure hydrocephalus: diagnostic and predictive value of clinical testing, lumbar drainage, and CSF dynamics. Full Text available with Trip Pro

Idiopathic normal pressure hydrocephalus: diagnostic and predictive value of clinical testing, lumbar drainage, and CSF dynamics. OBJECTIVE The aim of the study was to analyze the diagnostic and predictive values of clinical tests, CSF dynamics, and intracranial pulsatility tests, compared with external lumbar drainage (ELD), for shunt response in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Sixty-eight consecutive patients with suspected iNPH were prospectively (...) evaluated. Preoperative assessment included clinical tests, overnight intracranial pressure (ICP) monitoring, lumbar infusion test (LIFT), and ELD for 24-72 hours. Simple and multiple linear regression analyses were conducted to identify predictive parameters concerning the outcome after shunt therapy. RESULTS Positive response to ELD correctly predicted improvement after CSF diversion in 87.9% of the patients. A Mini-Mental State Examination (MMSE) value below 21 was associated with nonresponse after

2016 Journal of Neurosurgery

103. [Treatment of Idiopathic Normal-Pressure Hydrocephalus by Wuling Powder Combined Ventriculo- peritoneal Shunt Surgery: an Efficacy Observation]. (Abstract)

[Treatment of Idiopathic Normal-Pressure Hydrocephalus by Wuling Powder Combined Ventriculo- peritoneal Shunt Surgery: an Efficacy Observation]. Objective To observe the clinical efficacy of Wuling Powder (WP) combined ventricu- loperitoneal shunt surgery in patients with idiopathic normal-pressure hydrocephalus (INPH). Methods Totally 56 INPH patients were randomly assigned to the control group and the treatment group, 28 in each group. All patients received ventriculoperitoneal shunt surgery

2016 Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine Controlled trial quality: uncertain

104. A review of cognitive impairment and differential diagnosis in idiopathic normal pressure hydrocephalus Full Text available with Trip Pro

A review of cognitive impairment and differential diagnosis in idiopathic normal pressure hydrocephalus Idiopathic normal pressure hydrocephalus (iNPH) is a complex and still underestimated pathology. In the early stages, the cognitive profile is characterized mainly by impairments of attention, psychomotor speed and memory, suggesting frontal involvement; patients with more advanced iNPH show overall cognitive deterioration. The memory impairment, however, seems to be milder than that seen

2016 Functional Neurology

105. Small cisterno-lumbar gradient of phosphorylated Tau protein in geriatric patients with suspected normal pressure hydrocephalus Full Text available with Trip Pro

Small cisterno-lumbar gradient of phosphorylated Tau protein in geriatric patients with suspected normal pressure hydrocephalus The composition of the cerebrospinal fluid (CSF) is not homogeneous, and concentrations of proteins from different origins diverge among ventricular, cisternal and lumbar CSF fractions. Concentrations of blood-derived proteins increase and of brain-derived proteins decrease from ventricular to lumbar fractions. We studied whether the origin of the CSF portion analysed (...) may affect results in CSF analysis for dementia.In 16 geriatric patients with suspected normal pressure hydrocephalus [age 82.5 (76/87) years; median (25th/75th percentile)] a lumbar spinal tap of 40 ml was performed. The CSF was sequentially collected in 8 fractions of 5 ml with the 1st fraction corresponding to lumbar CSF, the 8th to cisterna magna-near CSF. Fractions were analysed for total protein, albumin, Tau protein (Tau), phosphorylated Tau (pTau), Amyloid beta 1-42 (Aβ1-42), Amyloid beta

2016 Fluids and barriers of the CNS

106. Normal Pressure Hydrocephalus in a Human Immunodeficiency Virus Type 1 Patient Full Text available with Trip Pro

Normal Pressure Hydrocephalus in a Human Immunodeficiency Virus Type 1 Patient Normal pressure hydrocephalus (NPH) is a relatively common disease of adulthood characterized by a typical combination of clinical and radiological findings. In this report, we discuss a 54-year-old female presenting with symptoms suggestive of NPH and found to have a history of human immunodeficiency virus (HIV) type 1. She was not treated as she was in denial state and developed NPH as a possible complication

2016 Journal of clinical medicine research

107. Nationwide Incidence of Normal Pressure Hydrocephalus (NPH) Assessed by Insurance Claim Data in Germany Full Text available with Trip Pro

Nationwide Incidence of Normal Pressure Hydrocephalus (NPH) Assessed by Insurance Claim Data in Germany The purpose of this study is to investigate the epidemiology of the idiopathic normal pressure hydrocephalus (iNPH) in Germany.The database of the nationwide Barmer Health Insurance was queried for specific combinations of corresponding International Classification of Diseases, Ninth Revision (ICD-9) codes and OPS codes (German modification of the ICPM and official classification of surgical

2016 The open neurology journal

108. A comparison between the pathophysiology of multiple sclerosis and normal pressure hydrocephalus: is pulse wave encephalopathy a component of MS? Full Text available with Trip Pro

A comparison between the pathophysiology of multiple sclerosis and normal pressure hydrocephalus: is pulse wave encephalopathy a component of MS? It has been suggested there is a chronic neurodegenerative disorder, underlying the pathophysiology of multiple sclerosis (MS), which is distinct from the more obvious immune-mediated attack on the white matter. Limited data exists indicating there is an alteration in pulse wave propagation within the craniospinal cavity in MS, similar to the findings (...) in normal pressure hydrocephalus (NPH). It is hypothesized MS may harbor pulse wave encephalopathy. The purpose of this study is to compare blood flow and pulse wave measurements in MS patients with a cohort of NPH patients and control subjects, to test this hypothesis.Twenty patients with MS underwent magnetic resonance (MR) flow quantification techniques. Mean blood flow and stroke volume were measured in the arterial inflow and venous out flow from the sagittal (SSS) and straight sinus (ST

2016 Fluids and barriers of the CNS

109. The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus Full Text available with Trip Pro

The Effect of Spinal Tap Test on Different Sensory Modalities of Postural Stability in Idiopathic Normal Pressure Hydrocephalus Postural instability in patients with normal pressure hydrocephalus (NPH) is a most crucial symptom leading to falls with secondary complications. The aim of the current study was to evaluate the therapeutic effect of spinal tap on postural stability in these patients.Seventeen patients with clinical symptoms of NPH were examined using gait scale, computerized dynamic

2016 Dementia and geriatric cognitive disorders extra

110. Spectrum of cognitive disorders in idiopathic normal pressure hydrocephalus Full Text available with Trip Pro

Spectrum of cognitive disorders in idiopathic normal pressure hydrocephalus Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by ventricular dilation accompanied by a progressive triad of a gait disturbance, "dementia" and incontinence. We retrospectively evaluated cognitive profile, and its relationship with disease variables, in 64 iNPH patients. The iNPH group performed significantly worse than the control group on all neuropsychological tests, except for verbal (...) memory (within the normal range). The patients were subdivided into four groups: group 1 (42%: global cognitive impairment); group 2 (24%: frontosubcortical dysfunction); group 3 (17%: isolated deficit of a single cognitive domain); group 4 (17%: no cognitive impairment). Group 1 was older, with a significantly longer disease duration and more severe motor disease, while groups 3 and 4 were younger and presented milder motor impairment and a shorter disease duration. These data suggest parallel

2016 Functional Neurology

111. NPH Log: Validation of a New Assessment Tool Leading to Earlier Diagnosis of Normal Pressure Hydrocephalus Full Text available with Trip Pro

NPH Log: Validation of a New Assessment Tool Leading to Earlier Diagnosis of Normal Pressure Hydrocephalus Early treatment of normal pressure hydrocephalus (NPH) yields better postoperative outcomes. Our current tests often fail to detect significant changes at early stages. We developed a new scoring system (LP log score) to determine if this tool is more sensitive in detecting clinical differences than current tests.Sixty-two consecutive new patients with suspected idiopathic NPH were studied

2016 Cureus

112. Neurosyphilis With Normal Pressure Hydrocephalus and Dementia Paralytica: Serial Clinical, Laboratory and Radiological Correlations in the 21st Century Full Text available with Trip Pro

Neurosyphilis With Normal Pressure Hydrocephalus and Dementia Paralytica: Serial Clinical, Laboratory and Radiological Correlations in the 21st Century We report a case of a 46-year-old man presenting with a progressive cognitive decline, ataxic gait, urinary incontinence for 4 months and neuroimaging consistent with normal pressure hydrocephalus. The atypical presentation of a progressively worsening dysphasia and a right hemiparesis dismissed as a vascular event 1 month earlier associated (...) with normal pressure hydrocephalus prompted further investigations confirming neurosyphilis also manifesting as dementia paralytica. Treatment using consensus guidelines led to resumption of activities of daily living. Neurosyphilis, considered rare in the neuroimaging era, must still be considered a reversible cause of dementia and other neurological manifestations in contemporary neurological practice.

2016 Neurology international

113. Diffusional Kurtosis Imaging in Idiopathic Normal Pressure Hydrocephalus: Correlation with Severity of Cognitive Impairment Full Text available with Trip Pro

Diffusional Kurtosis Imaging in Idiopathic Normal Pressure Hydrocephalus: Correlation with Severity of Cognitive Impairment Diffusional kurtosis imaging (DKI) is an emerging technique that describes diffusion of water molecules in terms of deviation from Gaussian distribution. This study investigated correlations between DKI metrics and cognitive function in patients with idiopathic normal pressure hydrocephalus (iNPH).DKI was performed in 29 iNPH patients and 14 age-matched controls. Mini

2016 Magnetic Resonance in Medical Sciences

114. Cerebral microbleeds in idiopathic normal pressure hydrocephalus Full Text available with Trip Pro

Cerebral microbleeds in idiopathic normal pressure hydrocephalus A vascular disease could be involved in pathophysiology of normal pressure hydrocephalus (INPH). If so, there should be an association between INPH and cerebral microbleeds (CMB). This study aims to analyze if CMB are associated with INPH.In this case-control study we included 14 patients with INPH (mean age 76 years, 60 % female) and 41 healthy controls (HeCo; mean age 71 years, 60 % female). All were investigated with magnetic

2016 Fluids and barriers of the CNS

115. Diagnosis and Treatment of Idiopathic Normal Pressure Hydrocephalus Full Text available with Trip Pro

Diagnosis and Treatment of Idiopathic Normal Pressure Hydrocephalus This article provides neurologists with a pragmatic approach to the diagnosis and treatment of idiopathic normal pressure hydrocephalus (iNPH), including an overview of: (1) key symptoms and examination and radiologic findings; (2) use of appropriate tests to determine the patient's likelihood of shunt responsiveness; (3) appropriate referral to tertiary centers with expertise in complex iNPH; and (4) the contribution

2016 Continuum : Lifelong Learning in Neurology

116. Segmentation and labeling of the ventricular system in normal pressure hydrocephalus using patch-based tissue classification and multi-atlas labeling Full Text available with Trip Pro

Segmentation and labeling of the ventricular system in normal pressure hydrocephalus using patch-based tissue classification and multi-atlas labeling Normal pressure hydrocephalus (NPH) affects older adults and is thought to be caused by obstruction of the normal flow of cerebrospinal fluid (CSF). NPH typically presents with cognitive impairment, gait dysfunction, and urinary incontinence, and may account for more than five percent of all cases of dementia. Unlike most other causes of dementia

2016 Proceedings of SPIE--the International Society for Optical Engineering

117. Idiopathic Normal Pressure Hydrocephalus: A Review for General Practitioners Full Text available with Trip Pro

Idiopathic Normal Pressure Hydrocephalus: A Review for General Practitioners Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurodegenerative disease commonly characterized by a triad of dementia, gait, and urinary disturbance. Advancements in diagnosis and treatment have aided in properly identifying and improving symptoms in patients. However, a large proportion of iNPH patients remain either undiagnosed or misdiagnosed. Using PubMed search engine of keywords (...) "normal pressure hydrocephalus," "diagnosis," "shunt treatment," "biomarkers," "gait disturbances," "cognitive function," "neuropsychology," "imaging," and "pathogenesis," articles were obtained for this review. The majority of the articles were retrieved from the past 10 years. The purpose of this review article is to aid general practitioners in further understanding current findings on the pathogenesis, diagnosis, and treatment of iNPH.

2016 Gerontology and geriatric medicine

118. Choroidal fissure acts as an overflow device in cerebrospinal fluid drainage: morphological comparison between idiopathic and secondary normal-pressure hydrocephalus Full Text available with Trip Pro

Choroidal fissure acts as an overflow device in cerebrospinal fluid drainage: morphological comparison between idiopathic and secondary normal-pressure hydrocephalus To clarify the pathogenesis of two different types of adult-onset normal-pressure hydrocephalus (NPH), we investigated cerebrospinal fluid distribution on the high-field three-dimensional MRI. The subarachnoid spaces in secondary NPH were smaller than those in the controls, whereas those in idiopathic NPH were of similar size

2016 Scientific reports

119. Early and delayed assessments of quantitative gait measures to improve the tap test as a predictor of shunt effectiveness in idiopathic normal pressure hydrocephalus Full Text available with Trip Pro

Early and delayed assessments of quantitative gait measures to improve the tap test as a predictor of shunt effectiveness in idiopathic normal pressure hydrocephalus To improve the diagnostic performance of the cerebrospinal fluid (CSF) tap test (TT), early and delayed assessments of gait were performed after the removal of 30 ml of CSF in patients with probable idiopathic normal pressure hydrocephalus. Assessments of gait included the 3-m timed up and go test (TUG), and the 10-m walk in time

2016 Fluids and barriers of the CNS

120. The APOE Genotype in Idiopathic Normal Pressure Hydrocephalus Full Text available with Trip Pro

The APOE Genotype in Idiopathic Normal Pressure Hydrocephalus Amyloid plaque has been reported in brain biopsies from patients with idiopathic normal-pressure hydrocephalus (iNPH) and proposed as a significant feature of the pathophysiology. Presence of the apolipoprotein E ε4 (APOE ε4) allele is associated with increased risk of Alzheimer's disease (AD).To compare the distribution of APOE genotype in iNPH patients with an age-matched population-based control group and with Alzheimer's disease

2016 PloS one

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