title: The grading of normal pressure hydrocephalus.
abstract: METHODS
  During a period of 15 years we investigated 200 patients suspected of normal pressure hydrocephalus (NPH) by means of an intrathecal infusion test. In 107 patients (54%) the diagnosis of a normal pressure hydrocephalus could be confirmed. For the evaluation of the course of disease we used the Black-Grading-Scale for shunt assessment [1] and the clinical grading for chronic hydrocephalus (Kiefer-scale) [4] pre- and postoperatively as well as in a follow-up examination seven months after surgical treatment. The aim of our study was to find out a quick and easy-to-handle bed-side examination for the grading of NPH.
  
  
  CONCLUSIONS
  The Black-Grading-Scale does not allow to distinguish between patients in an unchanged condition and those with a worsening of their symptoms. Therefore this scale is useful for patients with an obstructive hydrocephalus but not for those with a NPH. In our opinion the clinical grading of Kiefer [4] seems to be the most reliable scale for the grading and long term follow-up of a normal pressure hydrocephalus.
  
  
  CONCLUSIONS
  Our own created NPH-Recovery-Rate is based on the clinical grading for chronic hydrocephalus (Kiefer-scale) [4]. It allows the interindividual comparison between the courses of disease in patients with normal pressure hydrocephalus.
authors.affiliation: Department of Neurosurgery, Unfallkrankenhaus Berlin.
authors.forename: U
authors.initials: U
authors.lastname: Meier
mesh_terms: D001284:Atrophy; D001921:Brain / Q000473:pathology; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D002557:Cerebrospinal Fluid Shunts; D002908:Chronic Disease; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000145:classification* / Q000175:diagnosis / Q000601:surgery; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019095:Point-of-Care Systems