title: Changing cerebral blood flow in normal pressure hydrocephalus after the tap test can predict clinical improvement.
abstract: BACKGROUND
  We studied the role of cerebrospinal fluid (CSF) tap test at idiopathic normal pressure hydrocephalus (INPH) in improving cerebral blood flow velocity indices by transcranial Doppler (TCD) sonography.
  
  
  METHODS
  Twelve patients with assumed INPH were included in the study. The CSF tap test and INPH grading score was carried out according to the standard protocol. TCD was performed before and after the tap test for assessing blood flow in middle cerebral and anterior cerebral arteries.
  
  
  RESULTS
  Five INPH patients (41.7%) had clinical improvement as defined by at least one point reduction in INPH grading scale. The baseline TCD parameters of the middle cerebral artery were significantly higher compared with the control, and those parameters were decreased after tap test in those who improved.
  
  
  CONCLUSIONS
  Our study showed that improvement in INPH grading score after CSF tap test might correlate with changing in TCD parameter in MCA and TCD parameter might be useful for shunt response in these patients.
authors: Department of Neurology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors: Behnaz
authors: B
authors: Sedighi
authors: Department of Neurology, School of Medicine, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
authors: Kaveh
authors: K
authors: Shafiee
authors: Department of Neurology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
authors: Rostam
authors: R
authors: Seifaldini
authors: Department of Neurology, School of Medicine, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
authors: As'ad
authors: A
authors: Abdi
keywords: Cerebral Blood Flow; Normal Pressure Hydrocephalus; Transcranial Doppler Sonography
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