title: [Normal pressure hydrocephalus: A review and practical aspects].
abstract: Idiopathic normal pressure hydrocephalus is a chronic disorder affecting the elderly. It is defined by Adams and Hakim's triad in addition to ventricular dilation visible by brain imaging and normal cerebrospinal fluid pressure during lumbar puncture. The objective of this review was to propose a standard of care for idiopathic normal pressure hydrocephalus based on an extensive literature review conducted on 459 articles published over the last 10 years. Those articles were obtained by searching for the keywords "normal pressure hydrocephalus" in the PubMed database and selecting all the articles published in English or in French. The diagnosis of idiopathic normal pressure hydrocephalus is difficult because of commonly associated diseases, such as Alzheimer's disease and microangiopathy. Brain MRI is one of the key procedures to assist in the diagnosis of idiopathic normal pressure hydrocephalus. Indeed, the presence of certain MRI features is highly predictive of a positive tap test and shunt responsiveness. Nevertheless, tap test remains the standard of care for diagnosis. Continuous cerebrospinal fluid drainage test is an alternative because it improves the sensitivity of diagnosis (but is a more complicated test to perform). Alzheimer's biomarkers dosing in the cerebrospinal fluid seems interesting when diagnosis remains uncertain: the presence of Alzheimer's profile of the biological markers is predictive of a lower response to the tap test.
authors.affiliation: Service de neurologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37000 Tours, France; Université François-Rabelais, BP 3223, 37032 Tours cedex 01, France. Electronic address: m_mongin@hotmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Mongin
authors.affiliation: Université François-Rabelais, BP 3223, 37032 Tours cedex 01, France; Service de médecine interne gériatrique, centre mémoire ressources recherche (CMRR) de la région Centre, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France; Inserm U930, 37044 Tours cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Hommet
authors.affiliation: Université François-Rabelais, BP 3223, 37032 Tours cedex 01, France; Service de médecine interne gériatrique, centre mémoire ressources recherche (CMRR) de la région Centre, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France; Inserm U930, 37044 Tours cedex 9, France.
authors.forename: K
authors.initials: K
authors.lastname: Mondon
mesh_terms: D003663:Decision Trees; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis* / Q000628:therapy*; D017410:Practice Guidelines as Topic
keywords: Biomarkers; Biomarqueurs dans le liquide céphalorachidien; Cerebrospinal fluid removal; Diagnosis; Diagnostic; Hydrocéphalie à pression normale idiopathique; Idiopathic normal pressure hydrocephalus; Ponction lombaire soustractive; Traitement; Treatment