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Normal Pressure Hydrocephalus

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141. Pre-and postoperative cerebral blood flow changes in patients with idiopathic normal pressure hydrocephalus measured by computed tomography (CT)-perfusion. (PubMed)

Pre-and postoperative cerebral blood flow changes in patients with idiopathic normal pressure hydrocephalus measured by computed tomography (CT)-perfusion. In idiopathic normal pressure hydrocephalus (iNPH), the cerebral blood flow (CBF) is of pathophysiological interest and a potential biomarker. Computed tomography perfusion (CTP), an established technique with high spatial resolution and quantitative measurements, has not yet been used in the iNPH context. If CTP were sensitive to the CBF (...) reduced in normal appearing and periventricular white matter (PVWM), the lentiform nucleus and the global parenchyma. No CBF differences were shown between responders and non-responders. In responders, the CBF recovered postoperatively by 2.5-32% to approximately the level of HI, but remained significantly decreased in the PVWM of non-responders. The pre- and postoperative CBF of cortical and subcortical regions correlated with the intensity of symptoms. In spite of limited spatial coverage, CTP can

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2015 Journal of Cerebral Blood Flow and Metabolism

142. Reversible long-standing severe disability in idiopathic normal pressure hydrocephalus (PubMed)

Reversible long-standing severe disability in idiopathic normal pressure hydrocephalus 26716064 2019 02 27 2163-0402 5 6 2015 Dec Neurology. Clinical practice Neurol Clin Pract Reversible long-standing severe disability in idiopathic normal pressure hydrocephalus. 505-508 Selim Ayman M AM Division of Neurology (AMS, MF), Department of Medicine; Centre for Memory and Neurotherapeutics (CR), Department of Neuropsychology and Cognitive Health; Department of Physiotherapy (EK); and Rotman Research

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2015 Neurology: Clinical Practice

143. Prospective estimation of mean axon diameter and extra-axonal space of the posterior limb of the internal capsule in patients with idiopathic normal pressure hydrocephalus before and after a lumboperitoneal shunt by using q-space diffusion MRI (PubMed)

Prospective estimation of mean axon diameter and extra-axonal space of the posterior limb of the internal capsule in patients with idiopathic normal pressure hydrocephalus before and after a lumboperitoneal shunt by using q-space diffusion MRI To prospectively estimate the mean axon diameter (MAD) and extracellular space of the posterior limb of the internal capsule (PLIC) in patients with idiopathic normal pressure hydrocephalus (iNPH) before and after a lumboperitoneal (LP) shunting operation (...) diffusion MRI provides information on microstructural changes in the corticospinal tract • Lumboperitoneal (LP) shunting operation is useful for idiopathic normal pressure hydrocephalus • Q-space measurement may be a biomarker for the effect of the LP shunt procedure.

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2015 European radiology

144. A Clinical and Biochemical Analysis in the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus (PubMed)

A Clinical and Biochemical Analysis in the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus Idiopathic normal pressure hydrocephalus (iNPH) can be misdiagnosed with other neurodegenerative diseases, especially in the early disease stages. Considering the opportunity of the shunt surgery, iNPH should be diagnosed with accuracy. Here, we evaluate the utility of CSF biomarkers and their relationship with clinical features in the diagnosis of iNPH.We performed a multivariate

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2015 Frontiers in neurology

145. Epidemiology of Idiopathic Normal Pressure Hydrocephalus: A Systematic Review of the Literature. (PubMed)

Epidemiology of Idiopathic Normal Pressure Hydrocephalus: A Systematic Review of the Literature. Idiopathic normal pressure hydrocephalus (iNPH) is an important cause of gait disturbance and cognitive impairment in elderly adults. However, the epidemiology of iNPH is relatively unknown, largely as a result of the paucity of specifically designed population studies. This systematic review aims to assess the prevalence and incidence of iNPH.A systematic literature review on the epidemiology

2015 World neurosurgery

146. Three-dimensional observation of Virchow–Robin spaces in the basal ganglia and white matter and their relevance to idiopathic normal pressure hydrocephalus (PubMed)

Three-dimensional observation of Virchow–Robin spaces in the basal ganglia and white matter and their relevance to idiopathic normal pressure hydrocephalus Virchow-Robin spaces (VRS) are brain perivascular spaces containing perforating arteries. Although enlarged VRS are associated with various disorders such as Alzheimer's disease, cerebrovascular disease, and head trauma, their functional role remains unclear. Using highly fluid-sensitive magnetic resonance imaging (MRI) sequences, fine (...) morphological features of VRS and their relevance to idiopathic normal pressure hydrocephalus (iNPH) were investigated.Three-dimensional constructive interference in steady state (3D-CISS) on 3 Tesla MRI was applied to 29 individuals. The morphology and number of VRS in the basal ganglia and white matter were compared between 20 patients with iNPH and nine age-matched controls. The VRS number per hemisphere was classified into three grades: few, moderate, and abundant.Virchow-Robin spaces in the basal

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2015 Fluids and barriers of the CNS

147. Aspirin is associated with an increased risk of subdural hematoma in normal-pressure hydrocephalus patients following shunt implantation. (PubMed)

Aspirin is associated with an increased risk of subdural hematoma in normal-pressure hydrocephalus patients following shunt implantation. In this paper the authors investigate whether shunt-treated patients with normal-pressure hydrocephalus receiving aspirin therapy are at increased risk of developing subdural hematoma (SDH).Records from 80 consecutive patients who had undergone implantation of a cerebrospinal fluid shunt for the treatment of normal-pressure hydrocephalus were retrospectively (...) reviewed.Eleven cases of symptomatic SDH occurred, all among patients receiving aspirin or clopidogrel. The 5-year survival estimate was 0.3 (p < 0.0001) for users of aspirin and the hazard ratio was 12.8 (95% CI 3.1-53).Patients on an aspirin therapy regimen have a markedly increased risk of SDH after a shunt has been implanted for the treatment of normal-pressure hydrocephalus. Users of clopidogrel may have an even greater risk.

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2015 Journal of Neurosurgery

148. Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. (PubMed)

Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lumboperitoneal shunt surgery has the potential to alleviate symptoms of normal pressure hydrocephalus but the benefits of such surgery have not been tested in a randomised trial. The aim of this trial was to determine the safety and efficacy of the lumboperitoneal shunt surgery for this disorder.For the open-label randomised SINPHONI-2 trial, eligible participants (60-85 (...) years of age) with idiopathic normal pressure hydrocephalus, with ventriculomegaly, and tightness of the high-convexity and medial subarachnoid spaces on MRI, were recruited from 20 neurological and neurosurgical centres in Japan. Enrolled participants were randomly assigned in a 1:1 ratio according to a random code generated by the trial statistician, with a permuted block design (using a block size of 4 or 6) within each centre, to receive lumboperitoneal shunt surgery within 1 month after

2015 The Lancet. Neurology

149. Apathy, ventriculomegaly and neurocognitive improvement following shunt surgery in normal pressure hydrocephalus. (PubMed)

Apathy, ventriculomegaly and neurocognitive improvement following shunt surgery in normal pressure hydrocephalus. Apathy - impaired motivation and goal-directed behaviour - is a common yet often overlooked symptom in normal pressure hydrocephalus (NPH). Caudate atrophy often yields apathetic symptoms; however, this structural and functional relationship has not yet been explored in NPH. Additionally, little is known about the relationship between apathy and post-shunt cognitive recovery.This

2015 British Journal of Neurosurgery

150. Journal club: role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. (PubMed)

Journal club: role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. 24141398 2014 06 02 2018 12 02 1524-4040 73 5 2013 Nov Neurosurgery Neurosurgery Journal club: role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. 908-10 10.1227/NEU.0000000000000121 Ghobrial George (...) M GM Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Lang Michael J MJ eng Journal Article Comment United States Neurosurgery 7802914 0148-396X IM Neurosurgery. 2013 May;72(5):845-53; discussion 853-4 23313977 Neurosurgery. 2013 Nov;73(5):911-2 24141399 Endoscopy methods Female Humans Hydrocephalus, Normal Pressure pathology surgery Male Third Ventricle surgery Ventriculoperitoneal Shunt methods Ventriculostomy methods 2013 10 22 6 0 2013 10 22 6 0

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2014 Neurosurgery

151. Response to journal club: role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. (PubMed)

Response to journal club: role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. 24141399 2014 06 02 2018 12 02 1524-4040 73 5 2013 Nov Neurosurgery Neurosurgery Response to journal club: role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. 911-2 10.1227/NEU (...) .0000000000000126 Gomes Pinto Fernando Campos FC *Division of Functional Neurosurgery of the Institute of Psychiatry, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil; ‡Neurosurgery Residency Program-Department of Neurosurgery-Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil. de Oliveira Matheus Fernandes MF eng Letter Comment United States Neurosurgery 7802914 0148-396X IM Neurosurgery. 2013 Nov;73(5):908-10 24141398 Endoscopy methods Female Humans Hydrocephalus, Normal

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2014 Neurosurgery

152. Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus. (PubMed)

Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus. To investigate the impact of shunt surgery on the activity, participation, autonomy, and health-related quality of life (HRQOL) of patients with idiopathic normal-pressure hydrocephalus (iNPH) as well as the effect on caregiver burden.Thirty-seven patients (median age 70 years, range 50-89 years) with iNPH were evaluated before and 6 months after surgery. Symptoms (...) to the same level as found in the normal population. The patients became more independent in physical and cognitive activities, and participation and autonomy improved. The caregiver burden was decreased among caregivers to male patients but remained unchanged on the overall group level.After shunt surgery, patients with iNPH showed improvement in most aspects of social life, they became more independent, and their quality of life returned to nearly normal.

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2014 Journal of Neurosurgery

153. Outcome of modern shunt therapy in patients with idiopathic normal pressure hydrocephalus 6 years postoperatively. (PubMed)

Outcome of modern shunt therapy in patients with idiopathic normal pressure hydrocephalus 6 years postoperatively. Shunt therapy in idiopathic normal pressure hydrocephalus (iNPH) can improve symptoms in 84% of patients 1 year postoperatively. Therefore, implantation of a ventriculoperitoneal shunt (VPS) prevents or at least prolongs the time during which patients are not dependent on care from others because of gait disorder or dementia. In this study, the medium-term results of modern shunt

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2014 Journal of Neurosurgery

154. Should ventriculoatrial shunting be the procedure of choice for normal-pressure hydrocephalus? (PubMed)

Should ventriculoatrial shunting be the procedure of choice for normal-pressure hydrocephalus? Ventriculoatrial (VA) shunting is rarely used for patients with normal-pressure hydrocephalus (NPH), likely due to surgeon technical preference and case reports indicating cardiopulmonary complications. However, these complications have typically been limited to adults in whom VA shunts had been placed when they were children. Few studies have directly compared VA shunting to ventriculoperitoneal (VP

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2014 Journal of Neurosurgery

155. Prevalence of idiopathic normal-pressure hydrocephalus. (PubMed)

Prevalence of idiopathic normal-pressure hydrocephalus. The aim of this study was to determine the prevalence of idiopathic normal-pressure hydrocephalus (iNPH) in elderly persons in a large population-based sample using radiologic and clinical examinations.We examined representative elderly populations aged 70 years and older that had undergone neuropsychiatric evaluations and CT of the brain between 1986 and 2000 (n = 1,238). Gait was evaluated by clinical examination and history of walking

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2014 Neurology

156. Evaluation of coexistence of Alzheimer's disease in idiopathic normal pressure hydrocephalus using ELISA analyses for CSF biomarkers. (PubMed)

Evaluation of coexistence of Alzheimer's disease in idiopathic normal pressure hydrocephalus using ELISA analyses for CSF biomarkers. We investigated levels of the β-amyloid 1-42 (Aβ42), total tau protein (T-tau) and tau phosphorylated at position threonine 181 (P-tau) in cerebrospinal fluid (CSF) of idiopathic normal pressure hydrocephalus (iNPH) patients and tried to find their clinical implications in the evaluation and treatment of iNPH.Twenty-five possible iNPH patients were prospectively

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2014 BMC Neurology

157. Idiopathic normal pressure hydrocephalus: cerebral perfusion measured with pCASL before and repeatedly after CSF removal. (PubMed)

Idiopathic normal pressure hydrocephalus: cerebral perfusion measured with pCASL before and repeatedly after CSF removal. Pseudo-continuous arterial spin labeling (pCASL) measurements were performed in 20 patients with idiopathic normal pressure hydrocephalus (iNPH) to investigate whether cerebral blood flow (CBF) increases during the first 24 hours after a cerebrospinal fluid tap test (CSF TT). Five pCASL magnetic resonance imaging (MRI) scans were performed. Two scans were performed before

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2014 Journal of Cerebral Blood Flow and Metabolism

158. Alzheimer CSF biomarkers may be misleading in normal-pressure hydrocephalus. (PubMed)

Alzheimer CSF biomarkers may be misleading in normal-pressure hydrocephalus. This article discusses why CSF biomarkers found in normal-pressure hydrocephalus (NPH) can be misleading when distinguishing NPH from comorbid NPH with Alzheimer disease (AD).We describe NPH CSF biomarkers and how shunt surgery can change them. We hypothesize the effects that hydrocephalus may play on interstitial fluid space and amyloid precursor protein (APP) fragment drainage into the CSF based on a recent report (...) and how this may explain the misleading CSF NPH biomarker findings.In NPH, β-amyloid protein 42 (Aβ42) is low (as in AD), but total tau (t-tau) and phospho-tau (p-tau) levels are normal, providing conflicting biomarker findings. Low Aβ42 supports an AD diagnosis but tau findings do not. Importantly, not only Aβ42, but all APP fragments and tau proteins are low in NPH CSF. Further, these proteins increase after shunting. An increase in interstitial space and APP fragment drainage into the CSF during

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2014 Neurology

159. Normal Pressure Hydrocephalus Treatment by Acetazolamide

Normal Pressure Hydrocephalus Treatment by Acetazolamide Normal Pressure Hydrocephalus Treatment by Acetazolamide - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Normal Pressure Hydrocephalus Treatment (...) Steiner, Rabin Medical Center Study Details Study Description Go to Brief Summary: Normal pressure hydrocephalus (NPH) is an uncommon cause of dementia possibly reversible with treatment. First described in 1965 it consists of a triad of gait disturbance, cognitive deterioration, and urinary incontinence together with enlarged cerebral ventricles and normal cerebrospinal fluid (CSF) pressure. Foregoing trauma and hemorrhage, infection, mass lesions, or aqueductal stenosis can contribute

2014 Clinical Trials

160. Treatment and clinical outcome in patients with idiopathic normal pressure hydrocephalus--a systematic review. (PubMed)

Treatment and clinical outcome in patients with idiopathic normal pressure hydrocephalus--a systematic review. Treatment of idiopathic normal pressure hydrocephalus (iNPH) is challenging. It is well known that patients with iNPH experience short-term symptom relief after shunt implantation, but the long-term effect of shunting has yielded diverging results. The objective of the present study was to review the literature and to investigate the diagnostics, treatment and outcome of patients

2014 Danish medical journal

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