[Idiopathic normal pressure hydrocephalus].
Normal pressure hydrocephalus (NPH) is characterized by the classic triad of symptoms including gait disturbance, urinary incontinence, and dementia. Gait impairment represents the cardinal symptom. NPH is associated with a radiological verifiable ventriculomegaly in the absence of elevated cerebrospinal fluid (CSF) pressure. Because many patients do not present with classical clinical and radiological findings, its diagnosis and management represents a challenge for the general practitioner, neurologist and neurosurgeon. Various supplemental preoperative tests, including lumbar CSF tap test or CSF outflow resistance determination, can improve the accuracy of predicting a response to surgical intervention. CSF shunt results in significant symptoms in the majority of appropriately evaluated patients. The following article discusses clinical aspects, diagnosis and current therapeutic options.
Gautschi
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OP
Klinik für Neurochirurgie, Kantonsspital St. Gallen, Rorschacher Strasse 95, St. Gallen. Oliver.Gautschi@kssg.ch.
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Hildebrandt
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Fournier
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D000465:Algorithms; D001921:Brain / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology; D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D003937:Diagnosis, Differential; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000209:etiology; D013129:Spinal Puncture; D014057:Tomography, X-Ray Computed; D017287:Ventriculoperitoneal Shunt