Idiopathic normal pressure hydrocephalus (iNPH) and co-morbidity: an outcome analysis of 134 patients

Acta Neurochirurgica. Supplement
J Lemcke, U Meier

Abstract

The diagnosis and management of idiopathic normal-pressure hydrocephalus (iNPH) remains controversial, particularly in selecting patients for shunt insertion. Diagnostic criteria target the pathological features of the dynamics of the cerebrospinal fluid (CSF); however, the effectiveness in predicting the shunt success has room for improvement. The aim of our study was to systematically assess the influence of the co-morbidity determining the benefit from shunt surgery. Between 1997 and 2006 134 patients suffering from iNPH were treated with a ventriculo-peritoneal shunt with a gravity-controlled valve. The coincident disease processes were recorded. Shunt outcome was assessed at 2 years postsurgery in 116 patients (follow up rate 87%). The results of this follow-up examination (Kiefer score, NPH recovery rate) were compared using the preoperative co-morbidity index (CMI). Of the 134 patients 76 (56.7%) had a CMI of 0-3 and 58 patients (43.3%) had a CMI of 4-8. Two years after surgery 65 out of 70 shunt responders (93%) could be identified in the patients group with a CMI of 0-3 and only 29 of 46 (63%) in group with a CMI of 4-8. This difference was significant (p < 0.0001). Remarkably few patients scoring between 6 and 8 on th...Continue Reading

Citations

Oct 10, 2013·British Journal of Hospital Medicine·Menaka P ParanathalaErlick A C Pereira
Apr 24, 2015·Tijdschrift voor gerontologie en geriatrie·Wilhelmina Josephina Anna Remy Maria ValckxMarcel G M Olde Rikkert
Feb 13, 2020·British Journal of Neurosurgery·Katarina Ivana TudorFran Borovečki
Sep 23, 2020·Movement Disorders : Official Journal of the Movement Disorder Society·Alfonso FasanoJoachim K Krauss
Nov 4, 2015·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·I A Shamov
Jan 19, 2021·Neurologia Medico-chirurgica·Madoka NakajimaUNKNOWN research committee of idiopathic normal pressure hydrocephalus

❮ Previous
Next ❯

Related Concepts

Related Feeds

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.