Idiopathic normal pressure hydrocephalus: the CSF tap-test may predict the clinical response to shunting.
A follow-up study was performed in nine patients with idiopathic normal pressure hydrocephalus (NPH) 37 months (mean) after shunting and 10 non-operated controls with comparable degrees of ventricular enlargement, gait disorder, and dementia. Five operated patients vs. no controls reported sustained general improvement (p < 0.02). Objectively improved gait at follow-up (compared with preoperative status) was found in five of the six tested NPH-patients vs. none of the controls (p < 0.005). Improved gait and/or psychometric function was found in four of six NPH vs. none of eight control patients (p < 0.02) after drainage of 40 ml cerebrospinal fluid (CSF tap-test). Improved gait during the CSF tap-test predicted continued improvement at follow-up. Temporal horn size was the only radiological variable which showed a (moderate) positive correlation with resistance to CSF absorption and rate of pressure increase. The size of the third ventricle diminished in parallel with clinical improvement.
Sand
T
T
Department of Neurology, University Hospital, Trondheim, Norway.
Bovim
G
G
Grimse
R
R
Myhr
G
G
Helde
G
G
Cappelen
J
J
D000328:Adult; D000368:Aged; D002552:Cerebral Ventricles / Q000601:surgery; D002557:Cerebrospinal Fluid Shunts; D003704:Dementia / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000134:cerebrospinal fluid* / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome