title: Guidelines for management of idiopathic normal pressure hydrocephalus.
abstract: With the rapid aging of Japanese society, medical care of the elderly has become an important social issue. Among various disorders manifesting dementia, gait disturbance, and urinary incontinence in the elderly population, normal pressure hydrocephalus (NPH), especially of idiopathic type (iNPH), is becoming noteworthy. The Guidelines for management of iNPH in Japan are created in compliance with the evidence-based medicine methods and published in 2004. This English version is made to show the diagnosis and treatment of iNPH with reference to the socio-medical background in Japan and to promote the international research on iNPH. They propose three diagnostic levels; possible, probable, and definite. They indicate the diagnostic importance of high convexity tightness and dilated sylvian fissure with mild to moderate ventriculomegaly on coronal magnetic resonance imaging. The cerebrospinal fluid tap test is regarded as an important diagnostic test because of its simplicity to perform and high predictability of the shunt efficacy. The use of programmable valves at shunt surgeries is recommended. Flowcharts for diagnosis, preoperative assessment, and prevention for complications of shunt surgery are made to promote a wide use of them.
authors.affiliation: Kitano Hospital, Japan.
authors.forename: Masatsune
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Kuwana
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
authors.forename: Hiroji
authors.initials: H
authors.lastname: Miyake
authors.forename: Akihiko
authors.initials: A
authors.lastname: Wachi
authors.forename: Totaro
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kazui
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koyama
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology; D002535:Cerebral Aqueduct / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology; D002557:Cerebrospinal Fluid Shunts; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D007431:Intraoperative Complications / Q000517:prevention & control; D007564:Japan; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D009493:Neurosurgery / Q000295:instrumentation / Q000379:methods; D011300:Preoperative Care; D012720:Severity of Illness Index; D013129:Spinal Puncture; D014549:Urinary Incontinence / Q000175:diagnosis / Q000453:epidemiology