Repeated assessment of suspected normal pressure hydrocephalus in non-shunted cases. A prospective study based on the constant rate lumbar infusion test

Ryszard Czepko , Krzysztof Maria Cieślicki

Abstract

Background Only a few reports have been published on the natural history of non-shunted patients suspected of having NPH. The aim of this study is to follow up a group of such cases. Methods It was possible to follow up 27 patients who had not been qualified for shunting after the primary diagnosis. An assessment of Hakim ’ s triad was performed, together with an analysis of radiological parameters and the results of lum- bar infusion tests (LITs), both on admission and at the later date (on average, after 5.6 months). All parameters were ana- lyzed with respect to periventricular lucency (PVL), atrophy, type of NPH, and the age of the patients. Results There were no deteriorations and six patients im- proved. Those who were over 50 and who had no PVL or secondary NPH tended to improve more frequently. Significant improvement of dementia was noted ( p =0.042) in all cases, and in the group of patients without PVL ( p =0.04). The size of the ventricles did not change signifi- cantly. The values of the resistance to outflow (R), elastance (E), and ICP remained stable. Conclusions Analysis of our series revealed that the patients suspected of having NPH who had not been qualified for shunting did not deteriorate, while some of them even improved significantly as far as the level of dementia was concerned. As the CT and LIT parameters remained stable, there were no indications for repeating these examinations, at least within the period of nearly 6 months, which followed the primary diagnosis.
Author Ryszard Czepko - Department of Neurosurgery, St. Raphael’s Hospital Krakow Poland
Ryszard Czepko,,
-
, Krzysztof Maria Cieślicki IAR
Krzysztof Maria Cieślicki,,
- The Institute of Automatic Control and Robotics
Journal seriesActa Neurochirurgica, ISSN 0001-6268
Issue year2016
Vol158
No5
Pages855-863
Publication size in sheets0.5
Keywords in EnglishNormal pressure hydrocephalus, Non-shunted hydrocephalus, Lumbar infusion test, Repeated hydrodynamic test, Intracranial pressure – volume reserve
DOIDOI:10.1007/s00701-016-2732-5
URL http://link.springer.com/article/10.1007%2Fs00701-016-2732-5
Languageen angielski
Score (nominal)25
ScoreMinisterial score = 25.0, 28-11-2017, ArticleFromJournal
Ministerial score (2013-2016) = 25.0, 28-11-2017, ArticleFromJournal
Publication indicators WoS Impact Factor: 2016 = 1.881 (2) - 2016=2.121 (5)
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