Management of idiopathic normal-pressure hydrocephalus: a multi-institutional study conducted in Japan

Abstract

Patients suspected of having idiopathic NPH did not form a homogeneous group, making it difficult to select those who would most likely respond to CSF diversion. Of the diagnostic studies, the most reliable result was improvement in clinical symptoms following a lumbar puncture in which CSF was withdrawn. The use of a programmable valve is recommended because it offers advantages in preventing problems of over- and underdrainage.

Nationwide hospital‐based survey of idiopathic normal pressure hydrocephalus in Japan: Epidemiological and clinical characteristics

“…Regarding the clinical symptoms, according to the literature, gait impairment, cognitive decline, and urinary incontinence were observed in approximately 90–100%, 70–90%, and 50–80% of iNPH patients, respectively (Krauss et al., 1996; Mori, 2001). In this study, the frequency of patients with these symptoms was slightly lower, but gait impairment was found to be the most common, followed by cognitive decline and urinary incontinence.…”

“…In this study, the frequency of patients with these symptoms was slightly lower, but gait impairment was found to be the most common, followed by cognitive decline and urinary incontinence. However, only 12.1% of the patients had all three symptoms; thus, iNPH should still be considered when examining elderly patients with a reduced ADL level, even if they lack some symptoms (Mori, 2001). …”

Programmable valve represents an efficient and safe tool in the treatment of idiopathic normal-pressure hydrocephalus patients

“…

Idiopathic normal pressure hydrocephalus (iNPH) is a condition characterized by gait disturbance, dementia and/or urinary incontinence without causative disorders, as well as dilation of ventricular system due to disturbance of cerebrospinal fluid (CSF) circulation with normal CSF pressure and no secondary cause [1][2][3] . It is a differential diagnosis for most of the dementia syndromes and occurs mainly in elderly populations 4 .

The known incidence is approximately 6 per 100,000 and it has a prevalence of 22 per 100,000 for suspected iNPH.

There are associations with hypertension, cerebrovascular and Alzheimer diseases [1][2][3] .

The clinical evolution of iNPH is not clear 5 .

…”

“…It is a differential diagnosis for most of the dementia syndromes and occurs mainly in elderly populations 4 .The known incidence is approximately 6 per 100,000 and it has a prevalence of 22 per 100,000 for suspected iNPH.There are associations with hypertension, cerebrovascular and Alzheimer diseases [1][2][3] .The clinical evolution of iNPH is not clear 5 . Without surgery, most iNPH patients present early clinical deterioration.…”

“…Idiopathic normal pressure hydrocephalus (iNPH) is a condition characterized by gait disturbance, dementia and/or urinary incontinence without causative disorders, as well as dilation of ventricular system due to disturbance of cerebrospinal fluid (CSF) circulation with normal CSF pressure and no secondary cause [1][2][3] . It is a differential diagnosis for most of the dementia syndromes and occurs mainly in elderly populations 4 .…”