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Idiopathic normal pressure hydrocephalus: the CSF tap‐test may predict the clinical response to shunting
Author(s) -
Sand T.,
Bovim G.,
Grimse R.,
Myhr G.,
Helde G.,
Cappelen J.
Publication year - 1994
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1994.tb02640.x
Subject(s) - normal pressure hydrocephalus , shunting , cerebrospinal fluid , medicine , gait , central nervous system disease , hydrocephalus , anesthesia , surgery , cardiology , dementia , physical therapy , disease
A follow‐up study was performed in nine patients with idiopathic normal pressure hydrocephalus (NPH) 37 months (mean) after shunting and 10 non‐operated controls with comparable degrees of ventricular enlargement, gait disorder, and dementia. Five operated patients vs. no controls reported sustained general improvement (p<0.02). Objectively improved gait at follow‐up (compared with preoperative status) was found in five of the six tested NPH‐patients vs. none of the controls (p< 0.005). Improved gait and/or psychometric function was found in four of six NPH vs. none of eight control patients (p<0.02) after drainage of 40 ml cerebrospinal fluid (CSF tap‐test). Improved gait during the CSF tap‐test predicted continued improvement at follow‐up. Temporal horn size was the only radiological variable which showed a (moderate) positive correlation with resistance to CSF absorption and rate of pressure increase. The size of the third ventricle diminished in parallell with clinical improvement.