Impact of Cerebrovascular Disease on the Surgical Treatment of Idiopathic Normal Pressure Hydrocephalus

Spagnoli, D.; Innocenti, L.; Bello, Lorenzo; Pluderi, Mauro; Bacigaluppi, Susanna; Tomei, G.; Gaini, S. M.

doi:10.1227/01.neu.0000230259.49167.95

Cited by 27 publications

(32 citation statements)

References 27 publications

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“…Previous studies reported that NPH can coexist with other diseases, such as AD and CVD, and this may confound the diagnosis [27][28][29][30] . Comorbid CVD was reported to be present in 71% of the patients with iNPH who had received a ventriculoperitoneal shunt [30] . Of the NPH patients, 45% presented with one or more signs of CVD [28] .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Possible Idiopathic Normal-Pressure Hydrocephalus in Japan: The Osaki-Tajiri Project

et al. 2008

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Background: Several studies have reported that the prevalence of idiopathic normal-pressure hydrocephalus (iNPH) was between 0 and 5%. However, the precise prevalence in a community-based elderly population remains unclear. We investigated the prevalence of possible iNPH retrospectively using an age- and gender-stratified random sample database. Methods: Five hundred and sixty-seven participants were randomly selected from among the 1,654 members of the population aged 65 years and older in Tajiri, Japan, and 497 underwent MRI. We classified participants as having possible iNPH if they had: (1) ventricular enlargement, as shown by an Evans index of ≥0.3, with closing sulci at the high convexity with dilation of the sylvian fissure on MRI, (2) at least one of the iNPH clinical triad (gait disturbance, urinary incontinence and cognitive impairment), and (3) no identifiable potential secondary cause of hydrocephalus. Results: We found 7 participants who met the criteria mentioned above. Cognitive impairments were the most common symptoms (n = 6) followed by gait disturbances (n = 3); however, urinary incontinence was not observed. No full clinical triad was present in the patients and only 3 participants had 2 of the triad. Conclusions: We considered the prevalence of possible iNPH in elderly adults to be 1.4% (95% confidence interval = 0.6–2.9%).

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Section: Discussionmentioning

confidence: 99%

Prevalence of Possible Idiopathic Normal-Pressure Hydrocephalus in Japan: The Osaki-Tajiri Project

et al. 2008

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“…The likelihood of a positive lumbar tap test declines with increasing white matter burden [35]; however, small vessel white matter disease does not reduce the likelihood of improvement with VPS in those who have a positive ELD test [36]. MRI is better able to detect periventricular white matter changes than CT.…”

Section: Predictors Of Outcomementioning

confidence: 99%

Normal pressure hydrocephalus: Diagnosis and treatment

Shprecher

Schwalb²,

Kurlan³

2008

Curr Neurol Neurosci Rep

219

144

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Normal pressure hydrocephalus (NPH) is a syndrome of gait dysfunction and enlarged cerebral ventricles in the absence of another cause. It is frequently accompanied by frontal and subcortical cognitive deficits and bladder detrusor overactivity. NPH is rare relative to other potential causes of these symptoms in the elderly, but timely diagnosis can lead to reversal of symptoms through ventricular shunting. There are many tests used to predict possible response to surgery, such as MRI of the brain, formalized neuropsychological and gait testing, large-volume lumbar puncture, and prolonged lumbar drainage, but no one test has been validated to rule out potential response to surgery.

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“…Radiological examinations and imaging-related parameters of the CSDH were also were recorded and used to check whether the 2 patient groups were similar in these variables. The neurological co-morbidities of patients were established in the presence of at least one of the following criteria: 1) a documented history of ischemic or hemorrhagic stroke; 2) infarcts on the CT scan and/ or MRI performed on admission; and 3) a documented history of dementia, Parkinson diseases and/or hydrocephalus at least six months [10,11].…”

Section: Patient's Populationmentioning

confidence: 99%

Chronic Subdural Hematoma with Hypodense on CT-Scan in the Elderly: Surgical Drainage or Conservative Treatment

Wang¹,

Gu²,

Shi³

et al. 2016

J Neurol Neurosci

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Impact of Cerebrovascular Disease on the Surgical Treatment of Idiopathic Normal Pressure Hydrocephalus

Abstract: A high success rate in treatment of iNPH is possible in patients with and without CVD. Despite poorer short- and long-term treatment outcome of iNPH patients with CVD, a long-lasting improvement in their quality of life favors surgery.

Cited by 27 publications

References 27 publications

Prevalence of Possible Idiopathic Normal-Pressure Hydrocephalus in Japan: The Osaki-Tajiri Project

Prevalence of Possible Idiopathic Normal-Pressure Hydrocephalus in Japan: The Osaki-Tajiri Project

Normal pressure hydrocephalus: Diagnosis and treatment

Chronic Subdural Hematoma with Hypodense on CT-Scan in the Elderly: Surgical Drainage or Conservative Treatment

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