Quantitative evaluation of changes in gait after extended cerebrospinal fluid drainage for normal pressure hydrocephalus

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
Felix YangMark D Johnson

Abstract

Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait instability, urinary incontinence and cognitive dysfunction. These symptoms can be relieved by cerebrospinal fluid (CSF) drainage, but the time course and nature of the improvements are poorly characterized. Attempts to prospectively identify iNPH patients responsive to CSF drainage by evaluating presenting gait quality or via extended lumbar cerebrospinal fluid drainage (eLCD) trials are common, but the reliability of such approaches is unclear. Here we combine eLCD trials with computerized quantitative gait measurements to predict shunt responsiveness in patients undergoing evaluation for possible iNPH. In this prospective cohort study, 50 patients presenting with enlarged cerebral ventricles and gait, urinary, and/or cognitive difficulties were evaluated for iNPH using a computerized gait analysis system during a 3day trial of eLCD. Gait speed, stride length, cadence, and the Timed Up and Go test were quantified before and during eLCD. Qualitative assessments of incontinence and cognition were obtained throughout the eLCD trial. Patients who improved after eLCD underwent ventriculoperitoneal shunt placement, and symptoms were reassessed serially over th...Continue Reading

References

Nov 11, 2008·Journal of Neurosurgery·Andrew TarnarisLaurence D Watkins
Jul 2, 2010·The Neurologist·Robin K Wilson, Michael A Williams

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Citations

Jan 18, 2020·Journal of Neuroengineering and Rehabilitation·Alberto FerrariLorenzo Chiari
Dec 1, 2017·Neurology. Clinical Practice·Shigeki YamadaEtsuro Mori
Feb 2, 2019·Aging and Disease·Shigeki YamadaMasatsune Ishikawa
Oct 21, 2020·Journal of Neurology·Giovanni MostileMario Zappia
Jan 19, 2021·EMBO Molecular Medicine·Hong Wei YangMark D Johnson
Apr 2, 2021·Frontiers in Aging Neuroscience·Shigeki YamadaKazuhiko Nozaki

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