Normal pressure hydrocephalus: long-term outcome after shunt surgery

Pujari, Siddharth S.; Kharkar, Siddharth; Métellus, Philippe; Shuck, John; Williams, Michael A.; Rigamonti, Daniele

doi:10.1136/jnnp.2007.123620

Cited by 159 publications

(107 citation statements)

References 28 publications

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“…The efficacy of shunt procedures maintained for the short term ranged from 3-6 months in 64-96% of patients, 2,5,15,21,22,24,32,35,36,48) and at 1 year in 41-95% 10,12,18,25,33,40,49,50,62,66) ; while the efficacy of shunt procedures maintained for the long term ranged from 3-5 years in 28-91% of patients. 2,9,21,32,36,38,46,49,50,52) The best improvement rate was for gait disturbance, between 58-90%. 2,5,14,21,32,35,36,45,49,50,52,66) The improvement rate for dementia differed with the evaluation scale used; however, the symptoms improved in 29-80% of patients.…”

Section: Outcomementioning

confidence: 98%

“…2,9,21,32,36,38,46,49,50,52) The best improvement rate was for gait disturbance, between 58-90%. 2,5,14,21,32,35,36,45,49,50,52,66) The improvement rate for dementia differed with the evaluation scale used; however, the symptoms improved in 29-80% of patients. Urinary incontinence reportedly improved in 20-82.5% of patients.…”

Section: Outcomementioning

confidence: 99%

“…All of the MRI features may be partially corrected after shunt surgery (Recommendation grade B). 49,53) In addition, the callosal angle is steep . Each row contains a coronal T 1 -weighted image, a dorsal horizontal T 2 -weighted image, a horizontal T 1 -weighted image, and a horizontal T 2 -weighted image from a single patient.…”

Section: -A-i Brain Morphologymentioning

confidence: 99%

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Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

Mori

Ishikawa

Kato

et al. 2012

Neurol. Med. Chir.(Tokyo)

552

723

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Among the various disorders manifesting dementia, gait disturbance, and urinary incontinence in the elderly population, idiopathic normal pressure hydrocephalus (iNPH) is becoming of great importance. After the publication of the first edition of the Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus in 2004 (the English version was published in 2008), clinical awareness of iNPH has risen dramatically, and the number of shunt surgeries has increased rapidly across Japan. Clinical and basic research on iNPH has increased significantly, and more high-level evidence has since been generated. The second edition of the Japanese Guidelines was thus published in July 2011, to provide a series of timely evidence-based recommendations related to iNPH. The revision of the Guidelines has been undertaken by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydrocephalus in conjunction with the Japanese Ministry of Health, Labour and Welfare research project on``Studies on the epidemiology, pathophysiology, and treatment of normal pressure hydrocephalus.'' This English version of the second edition of the Guidelines was made to share these ideas with the international community and to promote international research on iNPH.

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Section: Outcomementioning

confidence: 98%

Section: Outcomementioning

confidence: 99%

See 1 more Smart Citation

Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

Mori

Ishikawa

Kato

et al. 2012

Neurol. Med. Chir.(Tokyo)

552

723

View full text Add to dashboard Cite

show abstract

“…17,22,23 We have no reason to believe that this is anything else than accidental. All patients were diagnosed based on clinical symptoms and MRI findings according to the guidelines and no supplementary tests were used for inclusion.…”

Section: Clinical Outcome and Study Designmentioning

confidence: 99%

Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus

Petersen

Hellström²,

Wikkelsø³

et al. 2014

JNS

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Object To investigate the impact of shunt surgery on the activity, participation, autonomy, and health-related quality of life (HRQOL) of patients with idiopathic normal-pressure hydrocephalus (iNPH) as well as the effect on caregiver burden. Methods Thirty-seven patients (median age 70 years, range 50–89 years) with iNPH were evaluated before and 6 months after surgery. Symptoms and signs were assessed by the iNPH scale, activities of daily living (ADL) with the Functional Independence Measure (FIM) and Assessment of Motor and Process Skills (AMPS), autonomy and participation with Impact on Participation and Autonomy (IPA), and caregiver burden with the Caregiver Burden Scale (CBS). HRQOL was evaluated with the EQ-5D (EuroQol Group–5 Dimension health survey). Results Twenty-four patients (65%) improved clinically (iNPH scale score) and 31 (86%) improved their HRQOL after surgery, almost to the same level as found in the normal population. The patients became more independent in physical and cognitive activities, and participation and autonomy improved. The caregiver burden was decreased among caregivers to male patients but remained unchanged on the overall group level. Conclusions After shunt surgery, patients with iNPH showed improvement in most aspects of social life, they became more independent, and their quality of life returned to nearly normal.

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“…Nevertheless, the LP shunt has been associated with higher failure rates compared to ventriculoperitoneal shunts [3][4][7][8][9][10][11][12][13]. However, the literature is characterized by lack of uniformity in reporting complication and surgical revision rates after LP shunting [4,[13][14][15]. Difference in the size of previous cohort studies as well as the tendency to under-report poor outcomes may at least in part explain this finding [3,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%