title: Natural history of idiopathic normal-pressure hydrocephalus.
abstract: Natural history of idiopathic normal-pressure hydrocephalus (INPH) is not clear. We performed a literature search for studies that looked into the outcome of unshunted INPH patients trying to answer the following questions: Do all INPH patients deteriorate without shunt? If yes, at what rate? Do some NPH patients improve without shunt? If yes, to what extent? Six studies objectively described the outcome of 102 INPH patients. Result shows that without surgery, most INPH patients had measurable deterioration as early as 3 months following initial assessment. A small number of patients might improve without shunt, however the extent of improvement is not clear. The homogeneity of the findings of the cohort studies provided high evidence supporting the rule of shunt surgery in INPH patients.
authors: Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. ahmedktoma@yahoo.com
authors: Ahmed K
authors: AK
authors: Toma
authors: Simon
authors: S
authors: Stapleton
authors: Marios C
authors: MC
authors: Papadopoulos
authors: Neil D
authors: ND
authors: Kitchen
authors: Laurence D
authors: LD
authors: Watkins
references: N Engl J Med. 1965 Jul 15;273:117-26
references: 14303656
references: J Neurosurg. 2006 Dec;105(6):815-22
references: 17405250
references: Neurosurgery. 2005 Sep;57(3 Suppl):S29-39; discussion ii-v
references: 16160427
references: J Neurol Neurosurg Psychiatry. 1978 Nov;41(11):961-71
references: 309503
references: Neurosurgery. 2001 Nov;49(5):1166-84; discussion 1184-6
references: 11846911
references: Acta Neurochir (Wien). 2007 Oct;149(10):983-90; discussion 990
references: 17676411
references: Neurol Med Chir (Tokyo). 2008;48 Suppl:S1-23
references: 18408356
references: Neurosurgery. 2005 Sep;57(3 Suppl):S4-16; discussion ii-v
references: 16160425
references: J Clin Neurosci. 2009 Sep;16(9):1180-3
references: 19497748
references: Nat Clin Pract Neurol. 2009 Feb;5(2):80-1
references: 19194387
references: Neurology. 2000 Aug 22;55(4):576-8
references: 10953197
references: Acta Neurochir (Wien). 2002 Jun;144(6):515-23; discussion 523
references: 12111484
references: Neurosurgery. 2005 Sep;57(3 Suppl):S17-28; discussion ii-v
references: 16160426
references: J Neurol Sci. 1965 Jul-Aug;2(4):307-27
references: 5889177
references: Cerebrospinal Fluid Res. 2008 Dec 16;5:19
references: 19087341
references: Eur Neurol. 2009;62(5):293-7
references: 19713705
references: Eur J Neurol. 2008 Jun;15(6):605-12
references: 18410369
references: AJNR Am J Neuroradiol. 2008 Jan;29(1):192-7
references: 17925364
references: Acta Neurochir (Wien). 2006 Nov;148(11):1151-6; discussion 1156
references: 17039303