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Outcomes and complications of different surgical treatments for idiopathic normalpressurehydrocephalus: a systematic review and meta-analysis OBJECTIVEDifferent CSF diversion procedures (ventriculoperitoneal, ventriculoatrial, and lumboperitoneal shunting) have been utilized for the treatment of idiopathic normalpressurehydrocephalus. 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
NormalpressurehydrocephalusNormalpressurehydrocephalus - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Normalpressurehydrocephalus 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 Normalpressurehydrocephalus (NPH), also known as idiopathic normalpressurehydrocephalus (INPH), is a condition characterised by the clinical features of hydrocephalus (i.e
A Review of Clinical Outcomes for Gait and Other Variables in the Surgical Treatment of Idiopathic NormalPressureHydrocephalus Idiopathic normalpressurehydrocephalus (INPH) is a treatable cause of gait disturbance, cognitive impairment, and urinary incontinence. This clinical triad of symptoms occurs in association with ventriculomegaly and normal cerebrospinal fluid (CSF) pressure. Although the treatment outcomes after CSF shunting for INPH have improved significantly since its first
Practice guideline: Idiopathic normalpressurehydrocephalus: Response to shunting and predictors of response: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology We evaluated evidence for utility of shunting in idiopathic normalpressurehydrocephalus (iNPH) and for predictors of shunting effectiveness.We identified and classified relevant published studies according to 2004 and 2011 American Academy of Neurology
Endoscopic third ventriculostomy (ETV) for idiopathic normalpressurehydrocephalus (iNPH). Idiopathic normalpressurehydrocephalus (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
Practice guideline: idiopathic normalpressurehydrocephalus: response to shunting and predictors of response Practice guideline: Idiopathic normalpressurehydrocephalus: Response to shunting and predictors of response | Neurology Advertisement Search for this keyword Main menu User menu Search Search for this keyword The most widely read and highly cited peer-reviewed neurology journal Share December 08, 2015 ; 85 (23) Special Article Practice guideline: Idiopathic normalpressure (...) .), Geisinger Medical Center, Danville, PA. Practice guideline: Idiopathic normalpressurehydrocephalus: Response to shunting and predictors of response John J. Halperin , Roger Kurlan , Jason M. Schwalb , Michael D. Cusimano , Gary Gronseth , David Gloss Neurology Dec 2015, 85 (23) 2063-2071; DOI: 10.1212/WNL.0000000000002193 Citation Manager Formats Make Comment See Comments Downloads 7838 Share This article has a correction. Please see: Abstract Objective: We evaluated evidence for utility of shunting
A randomized controlled dual-center trial on shunt complications in idiopathic normal-pressurehydrocephalus treated with gradually reduced or ``fixed`` pressure valve settings This study was undertaken to investigate whether a gradual reduction of the valve setting (opening pressure) decreases the complication rate in patients with idiopathic normal-pressurehydrocephalus (iNPH) treated with a ventriculoperitoneal (VP) shunt.In this prospective double-blinded, randomized, controlled, dual (...) -center study, a VP shunt with an adjustable valve was implanted in 68 patients with iNPH, randomized into two groups. In one group (the 20-4 group) the valve setting was initially set to 20 cm H₂O and gradually reduced to 4 cm H2O over the course of the 6-month study period. In the other group (the 12 group), the valve was kept at a medium pressure setting of 12 cm H₂O during the whole study period. The time to and type of complications (hematoma, infection, and mechanical problems) as well
A randomised trial of high and low pressure level settings on an adjustable ventriculoperitoneal shunt valve for idiopathic normalpressurehydrocephalus: results of the Dutch evaluation programme Strata shunt (DEPSS) trial In treating idiopathic normalpressurehydrocephalus (INPH) with a shunt there is always a risk of underdrainage or overdrainage. The hypothesis is tested whether patients treated using an adjustable valve preset at the highest opening pressure leads to comparable good (...) clinical results with less subdural effusions than in a control group with an opening pressure preset at a low pressure level.A multicentre prospective randomised trial was performed on a total of 58 patients suspected of INPH. Thirty patients were assigned to (control) group 1 and received a Strata shunt (Medtronic, Goleta, USA) with the valve preset at a performance level (PL) of 1.0, while 28 patients were assigned to group 2 and received a Strata shunt with the valve preset at PL 2.5. In this group
Flow-regulated versus differential pressure-regulated shunt valves for adult patients with normalpressurehydrocephalus. Since 1965 many ventriculo-peritoneal shunt systems have been inserted worldwide to treat hydrocephalus. The most frequent indication in adults is normalpressurehydrocephalus (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, "normalpressurehydrocephalus," iNPH, idiopathic normalpressurehydrocephalus, sNPH, and "secondary normalpressurehydrocephalus."We planned
Lumbar infusion test for the investigation of normalpressurehydrocephalus (IPG263) Overview | Lumbar infusion test for the investigation of normalpressurehydrocephalus | Guidance | NICE Lumbar infusion test for the investigation of normalpressurehydrocephalus Interventional procedures guidance [IPG263] Published date: June 2008 Share Save Guidance The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern (...) Ireland on the lumbar infusion test for the investigation of normalpressurehydrocephalus. Description Normalpressurehydrocephalus (NPH) is a condition in which a clear, colourless fluid called cerebrospinal fluid (or CSF) accumulates around the brain and spinal cord. Symptoms include abnormal gait, urinary incontinence and impaired cognitive function. NPH can be managed by surgical intervention, for example with shunt surgery. The lumbar infusion test may be useful for selecting those patients who