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Normal Pressure Hydrocephalus

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1401. Is the placement of shunts in patients with idiopathic normal-pressure hydrocephalus worth the risk? Results of a study based on continuous monitoring of intracranial pressure. (PubMed)

Is the placement of shunts in patients with idiopathic normal-pressure hydrocephalus worth the risk? Results of a study based on continuous monitoring of intracranial pressure. Data from many studies have demonstrated that shunt insertion in patients with idiopathic normal-pressure hydrocephalus (NPH) is associated with high morbidity and a lack of significant improvement; however, the use of strict diagnostic and treatment protocols can improve the results of surgery in these patients (...) of intracranial pressure was performed using a fiberoptic extradural sensor. In 31 patients cerebrospinal fluid dynamics were also determined. Eighty-six percent of patients showed clinical improvement after shunt insertion, 11.6% showed no change, and 2.3% exhibited some worsening. Gait improved in 81.4% of the patients, sphincter control in 69.8%, and cognitive dysfunction in 39.5%. There was no treatment-related death. Early or late postsurgical complications occurred in six patients (14%), although all

2004 Journal of Neurosurgery

1402. Lumbar cerebrospinal fluid pressure waves versus intracranial pressure waves in idiopathic normal pressure hydrocephalus. (PubMed)

Lumbar cerebrospinal fluid pressure waves versus intracranial pressure waves in idiopathic normal pressure hydrocephalus. The aim of this study was to explore how the lumbar cerebrospinal fluid pressure (CSFP) waves recorded during lumbar infusion compared with the intracranial pressure (ICP) waves recorded, either during lumbar infusion or during long-term, overnight monitoring. For this purpose, we assessed 27 simultaneous lumbar CSFP/ICP recordings made during lumbar infusion and 27 long (...) -term, overnight ICP recordings in 27 consecutive idiopathic normal pressure hydrocephalus (iNPH) patients. Pressure waves during lumbar infusion were explored by computing pulse pressure amplitude and mean single wave pressure of every corresponding CSFP/ICP wave pair; among our 27 lumbar CSFP/ICP recordings a total of 35,532 CSFP/ICP wave pairs were available for analysis. We as well computed mean values of pulse pressure amplitude (i.e. mean CSFP wave amplitude or mean ICP wave amplitude

2006 British Journal of Neurosurgery

1403. Evidence that congenital hydrocephalus is a precursor to idiopathic normal pressure hydrocephalus in only a subset of patients. (Full text)

Evidence that congenital hydrocephalus is a precursor to idiopathic normal pressure hydrocephalus in only a subset of patients. To identify the proportion of patients in a large idiopathic normal pressure hydrocephalus (INPH) cohort with large head circumference (HC) who presumably have congenital hydrocephalus that has not become clinically apparent until late in life.HC was measured in 158 patients diagnosed with communicating INPH and assigned to HC centile range adjusted for height and sex (...) . The proportion of patients with INPH and HC above the 97th, 90th or 50th centiles was compared with the proportion expected in a normal population.The proportion of patients with HC >90th centile was significantly larger than would be expected in a normal distribution (19.6% vs 10%, p = 0.0001), as was the proportion of patients with HC >97th centile (8.9% vs 3%, p = 0.0001). The relative association between INPH and HC >97th centile was nearly tripled (relative association 2.95; CI 1.36 to 6.41

2007 Neurosurgery and Psychiatry PubMed

1404. The predictive value of 5 days CSF diversion for shunting in normal pressure hydrocephalus. (Full text)

The predictive value of 5 days CSF diversion for shunting in normal pressure hydrocephalus. 3746321 1986 10 03 2018 11 13 0022-3050 49 7 1986 Jul Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry The predictive value of 5 days CSF diversion for shunting in normal pressure hydrocephalus. 842-3 Di Lauro L L Mearini M M Bollati A A eng Letter England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM Cerebrospinal Fluid Shunts Humans Hydrocephalus therapy (...) Hydrocephalus, Normal Pressure therapy 1986 7 1 1986 7 1 0 1 1986 7 1 0 0 ppublish 3746321 PMC1028918 Neurology. 1970 Jun;20(6):534-44 5463608 N Engl J Med. 1970 Sep 17;283(12):609-15 5450636 Arch Neurol. 1974 May;30(5):387-93 4544990 J Neurol Neurosurg Psychiatry. 1975 Sep;38(9):833-7 1185220 Clin Neurosurg. 1977;24:270-84 583685 Clin Neurosurg. 1977;24:285-315 583686 Clin Neurosurg. 1971;18:337-70 9015645 Brain. 1982 Mar;105(Pt 1):65-86 7066675 J Neurosurg. 1983 Sep;59(3):369-83 6886750 J Neurosurg. 1983

1986 Journal of neurology, neurosurgery, and psychiatry PubMed

1405. Non tumoral aqueduct stenosis and normal pressure hydrocephalus in the elderly. (Full text)

Non tumoral aqueduct stenosis and normal pressure hydrocephalus in the elderly. 3585398 1987 07 07 2018 11 13 0022-3050 50 5 1987 May Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry Non tumoral aqueduct stenosis and normal pressure hydrocephalus in the elderly. 648 Aoki N N eng Letter England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM Cerebral Aqueduct Constriction, Pathologic diagnosis Humans Hydrocephalus diagnosis Hydrocephalus, Normal Pressure

1987 Journal of neurology, neurosurgery, and psychiatry PubMed

1406. Reduction of ventricular size after shunting for normal pressure hydrocephalus related to CSF dynamics before shunting. (Full text)

Reduction of ventricular size after shunting for normal pressure hydrocephalus related to CSF dynamics before shunting. Reduction of ventricular size was determined by repeated computed tomography in 30 adult patients shunted for normal pressure hydrocephalus (NPH) and related to the pressure-volume index (PVI) and resistance to outflow of cerebrospinal fluid (Rcsf) measured before shunting. Rapid and marked reduction of ventricular size (n = 10) was associated with a significantly lower PVI

1988 Journal of neurology, neurosurgery, and psychiatry PubMed

1407. Normal pressure hydrocephalus and cerebrovascular disease: findings of postmortem. (Full text)

Normal pressure hydrocephalus and cerebrovascular disease: findings of postmortem. 2746280 1989 08 25 2018 11 13 0022-3050 52 6 1989 Jun Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry Normal pressure hydrocephalus and cerebrovascular disease: findings of postmortem. 804 Newton H H Pickard J D JD Weller R O RO eng Case Reports Letter England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM Aged Brain pathology Cerebral Ventricles pathology Dementia, Multi (...) -Infarct pathology Gliosis pathology Humans Hydrocephalus pathology Hydrocephalus, Normal Pressure pathology Male 1989 6 1 1989 6 1 0 1 1989 6 1 0 0 ppublish 2746280 PMC1032045 J Neurol Sci. 1970 Sep;11(3):205-42 5505685 Neurology. 1980 Sep;30(9):998-1000 7191546 Neuropathol Appl Neurobiol. 1987 Jul-Aug;13(4):309-20 3658108 J Neurol Neurosurg Psychiatry. 1985 Nov;48(11):1085-90 4078573

1989 Journal of neurology, neurosurgery, and psychiatry PubMed

1408. Three decades of normal pressure hydrocephalus: are we wiser now? (Full text)

Three decades of normal pressure hydrocephalus: are we wiser now? 8089664 1994 10 17 2018 11 13 0022-3050 57 9 1994 Sep Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry Three decades of normal pressure hydrocephalus: are we wiser now? 1021-5 Vanneste J A JA eng Editorial Review England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM J Neurol Neurosurg Psychiatry. 1995 Apr;58(4):520 7738584 Cerebrospinal Fluid Shunts Humans Hydrocephalus, Normal Pressure

1994 Journal of neurology, neurosurgery, and psychiatry PubMed

1409. Radiology rounds. The diagnosis is normal pressure hydrocephalus. The treatment is cerebrospinal shunting. (Full text)

Radiology rounds. The diagnosis is normal pressure hydrocephalus. The treatment is cerebrospinal shunting. 8616282 1996 06 07 2018 11 13 0008-350X 42 1996 Mar Canadian family physician Medecin de famille canadien Can Fam Physician Radiology rounds. The diagnosis is normal pressure hydrocephalus. The treatment is cerebrospinal shunting. 418-20, 422-3 McLennan M K MK Markham Stouffville Hospital in Markham, Ont. Margolis M M eng Case Reports Journal Article Canada Can Fam Physician 0120300 0008 (...) -350X IM Aged Cerebrospinal Fluid Shunts Diagnosis, Differential Female Humans Hydrocephalus, Normal Pressure diagnostic imaging surgery Tomography, X-Ray Computed 1996 3 1 1996 3 1 0 1 1996 3 1 0 0 ppublish 8616282 PMC2146308 J Neurol Sci. 1965 Jul-Aug;2(4):307-27 5889177 J Neurosurg. 1980 Mar;52(3):371-7 7359191

1996 Canadian Family Physician PubMed

1410. Comparative analysis of the gait disorder of normal pressure hydrocephalus and Parkinson's disease (Full text)

Comparative analysis of the gait disorder of normal pressure hydrocephalus and Parkinson's disease Comparative gait analyses in neurological diseases interfering with locomotion are of particular interest, as many hypokinetic gait disorders have the same main features. The aim of the present study was (1) to compare the gait disturbance in normal pressure hydrocephalus and Parkinson's disease; (2) to evaluate which variables of the disturbed gait pattern respond to specific treatment in both (...) diseases; and (3) to assess the responsiveness to visual and acoustic cues for gait improvement.In study 1 gait analysis was carried out on 11 patients with normal pressure hydrocephalus, 10 patients with Parkinson's disease, and 12 age matched healthy control subjects, on a walkway and on a treadmill. In study 2, patients with normal pressure hydrocephalus were reinvestigated after removal of 30 ml CSF, and patients with Parkinson's disease after administration of 150 mg levodopa. In part 3 visual

2001 Journal of neurology, neurosurgery, and psychiatry PubMed

1411. "Normal pressure hydrocephalus": what's in a name? (Full text)

"Normal pressure hydrocephalus": what's in a name? 12082036 2002 07 24 2017 11 14 0022-3050 73 1 2002 Jul Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry "Normal pressure hydrocephalus": what's in a name? 8 Dunn L L eng Comment Editorial England J Neurol Neurosurg Psychiatry 2985191R 0022-3050 IM J Neurol Neurosurg Psychiatry. 2002 Jul;73(1):9-12 12082037 Humans Hydrocephalus, Normal Pressure cerebrospinal fluid diagnosis physiopathology therapy Terminology

2002 Journal of neurology, neurosurgery, and psychiatry PubMed

1412. Hydrostatic and hydrodynamic considerations in shunted normal pressure hydrocephalus. (PubMed)

Hydrostatic and hydrodynamic considerations in shunted normal pressure hydrocephalus. Symptoms of overdrainage, a frequent complication following shunting procedures especially in patients with normal-pressure hydrocephalus (NPH), are presumed to be caused by siphoning: gravity-enhanced flow of cerebro spinal fluid (CSF) through shunts in upright position. A critical reappraisal of siphoning and overdrainage (OD) is presented considering the occurrence of subdural hygromas (SDH) encountered (...) in a group of patients shunted for NPH. The patients participated in the multicentre Dutch NPH study: 101 NPH patients were randomised for treatment with shunts with low or medium-high working pressure. Treatment with shunts with low working pressure resulted in an increased incidence of SDH (iSDH). Current physiological concepts of overdrainage are discussed and criticised. A new theory is presented on the basis of general physiological considerations. The theoretical model proposed yields a revised

2000 Acta neurochirurgica

1413. Effectiveness of shunting in patients with normal pressure hydrocephalus predicted by temporary, controlled-resistance, continuous lumbar drainage: a pilot study. (Full text)

Effectiveness of shunting in patients with normal pressure hydrocephalus predicted by temporary, controlled-resistance, continuous lumbar drainage: a pilot study. From 1984 to 1992 15 consecutive cases of normal pressure hydrocephalus were included in this pilot study. A series of tests included CT of the brain, grading of the cognitive mental state with the mini-mental state examination; urodynamic studies, and gait evaluation. These tests were carried out on admission, and repeated on day 1 (...) repeated one week after shunting and a year later. All the CRCLD responders continued to benefit from shunting at one week and one year after the procedure irrespective of the type of shunting they received. By comparison, none of the CRCLD non-responders showed any improvement a year after the shunting. In conclusion, CRCLD proved to be a safe and effective way to predict the effectiveness of shunting in patients with normal pressure hydrocephalus.

1994 Journal of neurology, neurosurgery, and psychiatry PubMed

1414. Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. (PubMed)

Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. Patient selection for cerebrospinal fluid diversion is difficult, because idiopathic normal pressure hydrocephalus (INPH) mimics other neurodegenerative disorders and no findings reliably predict outcome. The literature was reviewed to identify diagnostic criteria that predict shunt response and to formulate prognostic expectations.MEDLINE was searched, and 44 articles meeting predetermined criteria were (...) included.Clinical series were frequently retrospective with small patient numbers and unstandardized outcome evaluation. Clinical findings suggestive of shunt responsiveness were the complete triad (gait disturbance, urinary incontinence, and dementia) with early gait disturbance. Degree of hydrocephalus was not correlated with clinical improvement. Reduction of the subcortical low-blood flow area was correlated with improvement in three small studies. Clinical response to prolonged cerebrospinal fluid drainage

2001 Neurosurgery

1415. Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus. (Full text)

Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus. To compare the lumbar infusion test and the cerebrospinal fluid (CSF) tap test for predicting the outcome of shunt surgery in patients with suspected normal pressure hydrocephalus.68 patients with suspected normal pressure hydrocephalus were studied. The absence of preceding history indicated idiopathic disease in 75% of these. All patients were assessed (...) a positive outcome of shunt operations in unselected patients with suspected normal pressure hydrocephalus. The two tests are complementary and should be used together for optimal patient selection.

2002 Neurosurgery and Psychiatry PubMed

1416. Obsessive-compulsive symptomatology in normal pressure hydrocephalus: a case report. (Full text)

Obsessive-compulsive symptomatology in normal pressure hydrocephalus: a case report. This report describes a patient with a DSM-III-R diagnosis of obsessive compulsive disorder and a nuclear magnetic resonance picture of a normal pressure hydrocephalus. After neurosurgery, the patient showed marked improvement in his compulsions which previously had shown little response to pharmacological treatment.

1994 Journal of Psychiatry and Neuroscience PubMed

1417. Simultaneous recording of cerebrospinal fluid pressure and middle cerebral artery blood flow velocity in patients with suspected symptomatic normal pressure hydrocephalus. (Full text)

Simultaneous recording of cerebrospinal fluid pressure and middle cerebral artery blood flow velocity in patients with suspected symptomatic normal pressure hydrocephalus. CSF pressure (intracranial pressure, in one patient lumbar pressure) was monitored continuously for one night in 23 patients with suspected symptomatic normal pressure hydrocephalus (NPH) to identify patients who might benefit from subsequent shunt surgery. In 20 patients middle cerebral artery (MCA) blood flow velocity (...) by means of transcranial Doppler sonography (TCD) and CSF pressure were recorded simultaneously. In three patients transcranial Doppler signals were insufficient. Spontaneous changes in CSF pressure always paralleled changes in the TCD signal. Equivalents of B-waves as well as intermediate waves (in between B- and A-waves), and C-waves could be identified easily and always appeared in phase. The Doppler signal, however, could not be used to evaluate the absolute changes in CSF pressure. Fast Fourier

1993 Journal of neurology, neurosurgery, and psychiatry PubMed

1418. Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts. (PubMed)

Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts. The goal of this prospective study was to compare outcome after placement of a low- or medium-pressure shunt in patients with normal-pressure hydrocephalus (NPH).Ninety-six patients with NPH were randomized to receive a low-pressure ventriculoperitoneal shunt (LPV; 40 +/- 10 mm H2O) or medium high-pressure ventriculoperitoneal shunt (MPV; 100 +/- 10 mm H2O). The patients' gait disturbance

1998 Journal of neurosurgery

1419. Intracranial cerebrospinal fluid measurement studies in suspected idiopathic normal pressure hydrocephalus, secondary normal pressure hydrocephalus, and brain atrophy. (Full text)

Intracranial cerebrospinal fluid measurement studies in suspected idiopathic normal pressure hydrocephalus, secondary normal pressure hydrocephalus, and brain atrophy. To investigate intracranial cerebrospinal fluid (CSF) distribution in patients with a clinical diagnosis of idiopathic normal pressure hydrocephalus (INPH).24 patients with a clinical diagnosis of INPH were studied. Control groups comprised 17 patients with secondary normal pressure hydrocephalus (SNPH), 21 patients with brain

2002 Neurosurgery and Psychiatry PubMed

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