Concurrent Alzheimer's pathology in patients with clinical normal pressure hydrocephalus: correlation of high-volume lumbar puncture results, cortical brain biopsies, and outcomes

Journal of Neurosurgery
I Jonathan PomeraniecJohn A Jane

Abstract

Normal pressure hydrocephalus (NPH) remains most often a clinical diagnosis and has been widely considered responsive to the placement of a cerebrospinal fluid (CSF) shunt. The high incidence of patients with Alzheimer's disease (AD) with NPH symptoms leads to poorer outcomes than would be expected in patients with NPH alone. This article reviews a series of patients operated on for presumed NPH in whom preoperative high-volume lumbar puncture (HVLP) and intraoperative cortical brain biopsies were performed. The data derived from these procedures were then used to understand the incidence of AD in patients presenting with NPH symptoms and to analyze the efficacy of HVLP in patients with NPH and patients with concurrent AD (NPH+AD). A review of the outcomes of shunt surgery is provided. The cases of all patients who underwent placement of a CSF shunt for NPH from 1998 to 2013 at the University of Virginia by the senior author were retrospectively reviewed. Patients who underwent HVLP and patients who underwent cortical brain biopsies were stratified based on the biopsy results into an NPH-only group and an NPH+AD group. The HVLP results and outcomes were then compared in these 2 groups. From 1998 to 2013, 142 patients underwent ...Continue Reading

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Citations

Jan 20, 2018·Journal of Neurosurgery·Sami Abu HamdehNiklas Marklund
Nov 22, 2018·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Kyan YounesUNKNOWN Alzheimer's Disease Neuroimaging Initiative Researchers
Jan 25, 2019·Acta Neurologica Scandinavica·Melissa SongJiong Shi
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Feb 16, 2018·Journal of Neurosurgical Sciences·I Jonathan PomeraniecM Beatriz Lopes
Mar 1, 2016·Acta Neurologica Scandinavica·S YamadaUNKNOWN SINPHONI-2 Investigators (Appendix)
Jul 10, 2019·Dementia & Neuropsychologia·Louise Makarem OliveiraGustavo C Román
Sep 21, 2016·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A JunkkariV Leinonen
Dec 6, 2020·Journal of the Neurological Sciences·Tiberiu LaticevschiGilles Allali
Jan 22, 2021·Acta neurochirurgica·Joachim M K Oertel, Matthias J M Huelser
Jan 22, 2020·Trends in Molecular Medicine·Benjamin C ReevesKristopher T Kahle
Jun 20, 2021·La Revue de médecine interne·P RoblotV Jecko

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Methods Mentioned

BETA
biopsies
biopsy
brain

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