Assessment of idiopathic normal pressure patients in neurological practice: the role of lumbar infusion testing for referral of patients to neurosurgery

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
A Brean, P K Eide

Abstract

In neurological practice patients with tentative idiopathic normal pressure hydrocephalus (iNPH) usually are referred to neurosurgery based on clinical and radiological findings. Hydrodynamic assessment using lumbar infusion testing might be helpful in selecting patients. To retrospectively analyse lumbar infusion tests done in neurological practice in iNPH patients to see how infusion test results relate to the clinical course and shunt response. Sixty-three consecutive patients with Possible/Probable iNPH were tested during a 1-year period. The pre-operative lumbar infusion tests were assessed according to two strategies: (i) Determining the resistance to cerebrospinal fluid (CSF) outflow (R(out)). (ii) Quantification of the CSF pressure (CSFP) pulsatility during lumbar infusion (Q(pulse)). The results were related to the prospectively followed clinical course and shunt response after 12 months. The lumbar infusion-derived parameters R(out) and Q(pulse) related weakly. Shunt response after 12 months was not related to R(out), but was highly related to the Q(pulse). False negative results of lumbar infusion testing were observed in 16% of the patients. In neurological practice lumbar infusion testing may be useful for determin...Continue Reading

References

Nov 9, 2005·Medical Engineering & Physics·Per Kristian Eide

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Citations

May 20, 2011·Neurosurgical Review·Ahmed K TomaLaurence D Watkins
Jan 17, 2009·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·K Kilic
Feb 26, 2011·Fluids and Barriers of the CNS·Mark E WagshulJoseph R Madsen
Dec 3, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Kerstin AndrénPer Hellström
May 11, 2012·Acta Neurologica Scandinavica·P KlingeUNKNOWN European iNPH Multicentre Study Group
Oct 18, 2014·Neurological Research·Dong-Joo KimMarek Czosnyka
Jun 9, 2009·International Review of Neurobiology·Glen R Finney
Feb 20, 2014·American Journal of Alzheimer's Disease and Other Dementias·Sayantani Ghosh, Carol Lippa
Jan 19, 2021·Neurologia Medico-chirurgica·Madoka NakajimaUNKNOWN research committee of idiopathic normal pressure hydrocephalus
Apr 28, 2021·Clinical Neurology and Neurosurgery·Ryo OikeTakatoshi Sorimachi

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