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The prognostic value of clinical characteristics and parameters of cerebrospinal fluid hydrodynamics in shunting for idiopathic normal pressure hydrocephalus

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An Erratum to this article was published on 01 January 2006

Summary

Background. It is difficult to predict which patients with symptoms and radiological signs of normal pressure hydrocephalus (NPH) will benefit from a shunting procedure and which patients will not. Risk of this procedure is also higher in patients with NPH than in the overall population of hydrocephalic patients. The aim of this study is to investigate which clinical characteristics, CT parameters and parameters of cerebrospinal fluid dynamics could predict improvement after shunting.

Methods. Eighty-three consecutive patients with symptoms and radiological signs of NPH were included in a prospective study. Parameters of the cerebrospinal fluid dynamics were measured by calculation of computerised data obtained by a constant-flow lumbar infusion test. Sixty-six patients considered candidates for surgery were treated with a medium-pressure Spitz-Holter valve; in seventeen patients a shunting procedure was not considered indicated. Clinical and radiological follow-up was performed for at least one year postoperatively.

Findings. The odds ratio, the sensitivity and specificity as well as the positive and negative predictive value of individual and combinations of measured parameters did not show a statistically significant relation to clinical improvement after shunting.

Conclusions. We conclude that neither individual parameters nor combinations of measured parameters show any statistically significant relation to clinical improvement following shunting procedures in patients suspected of NPH. We suggest restricting the term normal pressure hydrocephalus to cases that improve after shunting and using the term normal pressure hydrocephalus syndrome for patients suspected of NPH and for patients not improving after implantation of a proven well-functioning shunt.

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References

  • MJ Albeck SE Borgesen F Gjerris JF Schmidt PS Sorensen (1991) ArticleTitleIntracranial pressure and cerebrospinal fluid outflow conductance in healthy subjects. J Neurosurg 74 IssueID4 597–600 Occurrence Handle1:STN:280:By6C283jtl0%3D Occurrence Handle2002373

    CAS  PubMed  Google Scholar 

  • Z Czosnyka M Czosnyka PC Whitfield T Donovan JD Pickard (2002) ArticleTitleCerebral autoregulation among patients with symptoms of hydrocephalus. Neurosurgery 50 IssueID3 526–532 Occurrence Handle11841720

    PubMed  Google Scholar 

  • P Klinge G Berding T Brinker M Schuhmann E Weckesser WH Knapp M Samii (2002) ArticleTitleThe role of cerebral blood flow and cerebrovascular reserve capacity in the diagnosis of chronic hydrocephalus – a PET-study on 60 patients. Acta Neurochir (Wien) [Suppl] 81 39–41 Occurrence Handle1:STN:280:DC%2BD38vhsVCqsg%3D%3D

    CAS  Google Scholar 

  • J Malm B Lundkvist A Eklund LO Koskinen B Kristensen (2004) ArticleTitleCSF outflow resistance as predictor of shunt function. A long-term study. Acta Neurol Scand 110 IssueID3 154–160 Occurrence Handle10.1111/j.1600-0404.2004.00302.x Occurrence Handle1:STN:280:DC%2BD2czot1aqsA%3D%3D Occurrence Handle15285771

    Article  CAS  PubMed  Google Scholar 

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An erratum to this article is available at http://dx.doi.org/10.1007/s00701-005-0709-x.

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Delwel, E., de Jong, D. & Avezaat, C. The prognostic value of clinical characteristics and parameters of cerebrospinal fluid hydrodynamics in shunting for idiopathic normal pressure hydrocephalus. Acta Neurochir (Wien) 147, 1037–1043 (2005). https://doi.org/10.1007/s00701-005-0570-y

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  • DOI: https://doi.org/10.1007/s00701-005-0570-y

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