Idiopathic normal pressure hydrocephalus: diagnostic and predictive value of clinical testing, lumbar drainage, and CSF dynamics

Journal of Neurosurgery
Cynthia V MahrJürgen Meixensberger

Abstract

OBJECTIVE The aim of the study was to analyze the diagnostic and predictive values of clinical tests, CSF dynamics, and intracranial pulsatility tests, compared with external lumbar drainage (ELD), for shunt response in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Sixty-eight consecutive patients with suspected iNPH were prospectively evaluated. Preoperative assessment included clinical tests, overnight intracranial pressure (ICP) monitoring, lumbar infusion test (LIFT), and ELD for 24-72 hours. Simple and multiple linear regression analyses were conducted to identify predictive parameters concerning the outcome after shunt therapy. RESULTS Positive response to ELD correctly predicted improvement after CSF diversion in 87.9% of the patients. A Mini-Mental State Examination (MMSE) value below 21 was associated with nonresponse after shunt insertion (specificity 93%, sensitivity 67%). Resistance to outflow of CSF (ROut) > 12 mm Hg/ml/min was false negative in 21% of patients. Intracranial pulsatility parameters yielded different results in various parameters (correlation coefficient between pulse amplitude and ICP, slow wave amplitude, and mean ICP) but did not correlate to outcome. In multiple linear re...Continue Reading

References

Nov 1, 1975·Journal of Psychiatric Research·M F FolsteinP R McHugh
Dec 1, 1991·Journal of Neurology, Neurosurgery, and Psychiatry·B FarrellC Warlow
Oct 1, 1974·Journal of Neurosurgery·S C Stein, T W Langfitt
Sep 17, 2003·Zentralblatt für Neurochirurgie·M KieferW I Steudel
Feb 9, 2006·Acta Neurochirurgica. Supplement·Z CzosnykaJ D Pickard
Jul 7, 2007·Neurosurgical Focus·Marek CzosnykaJohn D Pickard
Jul 7, 2007·Neurosurgical Focus·Marek CzosnykaJohn D Pickard
Apr 19, 2008·Journal of Neurochemistry·Daniel KondziellaCarsten Wikkelso
Jan 1, 2008·Acta Neurochirurgica. Supplement·Z CzosnykaM Czosnyka
Jun 24, 2010·Neurosurgery·Matthew B Wallenstein, Guy M McKhann
Apr 6, 2012·Acta Neurochirurgica. Supplement·Peter SmielewskiMarek Czosnyka
Apr 6, 2012·Acta Neurochirurgica. Supplement·Andreas SpeilMartin U Schuhmann
Dec 20, 2012·Journal of Neurology, Neurosurgery, and Psychiatry·Carsten WikkelsøUNKNOWN European iNPH Multicentre Study Group
Jul 9, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·M PreussM Dengl
Dec 3, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Kerstin AndrénPer Hellström
Oct 18, 2014·Neurological Research·Dong-Joo KimMarek Czosnyka

❮ Previous
Next ❯

Citations

Jan 20, 2017·Frontiers in Aging Neuroscience·Stefan SchobMatthias Preuß
Dec 4, 2019·Current Treatment Options in Neurology·Albert M IsaacsMark G Hamilton
Oct 21, 2020·Journal of Neurology·Giovanni MostileMario Zappia
May 12, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Unal OzturkAhmet Adiguzel

❮ Previous
Next ❯

Methods Mentioned

BETA
RAP

Software Mentioned

LIFT
ICM
SPSS
R

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.