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Idiopathic normal pressure hydrocephalus

Antti J Luikku, Anette Hall, Ossi Nerg, Anne M Koivisto, Mikko Hiltunen, Seppo Helisalmi, Sanna-Kaisa Herukka, Anna Sutela, Maria Kojoukhova, Jussi Mattila, Jyrki Lötjönen, Jaana Rummukainen, Irina Alafuzoff, Juha E Jääskeläinen, Anne M Remes, Hilkka Soininen, Ville Leinonen
OBJECTIVES: Optimal selection of idiopathic normal pressure hydrocephalus (iNPH) patients for shunt surgery is challenging. Disease State Index (DSI) is a statistical method that merges multimodal data to assist clinical decision-making. It has previously been shown to be useful in predicting progression in mild cognitive impairment and differentiating Alzheimer's disease (AD) and frontotemporal dementia. In this study, we use the DSI method to predict shunt surgery response for patients with iNPH...
October 14, 2016: Acta Neurochirurgica
Tricia Adjei, Daniel Abásolo, David Santamarta
Hydrocephalus is a condition characterised by enlarged cerebral ventricles, which in turn affects intracranial pressure (ICP); however, the mechanisms regulating ICP are not fully understood. A nonlinear signal processing approach was applied to ICP signals measured during infusion studies from patients with two forms of hydrocephalus, in a bid to compare the differences. This is the first study of its kind. The two forms of hydrocephalus were idiopathic normal pressure hydrocephalus (iNPH) and secondary normal pressure hydrocephalus (SH)...
September 2016: Healthcare Technology Letters
Emilio Luis González-Martínez, David Santamarta
BACKGROUND: Late-onset idiopathic aqueductal stenosis may present with clinical features indistinct from idiopathic normal-pressure hydrocephalus (NPH). Moreover, aqueductal stenosis (AS) is not always detected by conventional magnetic resonance imaging (MRI). The aim of this study was to compare the hydrodynamic pattern among NPH patients according to the patency of the aqueduct. METHODS: Fifty-six consecutive lumbar infusion tests were performed in patients with NPH syndrome...
October 11, 2016: Acta Neurochirurgica
Claudia L Craven, Ahmed K Toma, Tarek Mostafa, Neekhil Patel, Laurence D Watkins
OBJECTIVE: Selecting probable idiopathic normal pressure hydrocephalus (INPH) patients for shunt insertion presents a challenge because of coexisting comorbidities and other conditions that could mimic NPH. The characteristic appearance of DESH (Disproportionately Enlarged Subarachnoid Space Hydrocephalus) on brain imaging has been shown to have a high positive predictive value in identifying shunt responsive INPH patients (SINPHONI trial). However, the negative predictive value of this radiological sign was not clearly demonstrated...
September 28, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Patrick M House, Stefan R G Stodieck
OBJECTIVE: Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without a space-occupying cerebral lesion, venous sinus thrombosis or hydrocephalus and with normally composited cerebrospinal fluid (CSF). Main symptoms are headache, sight disturbances and potential visual impairment. Weight loss, carbonic anhydrase inhibitors, lumbar punctures with CSF drain, CSF shunting, optic nerve sheath fenestration, and venous sinus stenting are common IIH therapies...
November 2016: Clinical Neurology and Neurosurgery
Thu-Trang Hickman, Matthew E Shuman, Tatyana A Johnson, Felix Yang, Rebecca R Rice, Isaac M Rice, Esther H Chung, Robert Wiemann, Megan Tinl, Christine Iracheta, Grace Chen, Patricia Flynn, Mary Beth Mondello, Jillian Thompson, Mary-Ellen Meadows, Rona S Carroll, Hong Wei Yang, Hongyan Xing, David Pilgrim, E Antonio Chiocca, Ian F Dunn, Alexandra J Golby, Mark D Johnson
OBJECTIVE Idiopathic normal pressure hydrocephalus (iNPH) is characterized by ventriculomegaly, gait difficulty, incontinence, and dementia. The symptoms can be ameliorated by CSF drainage. The object of this study was to identify factors associated with shunt-responsive iNPH. METHODS The authors reviewed the medical records of 529 patients who underwent shunt placement for iNPH at their institution between July 2001 and March 2015. Variables associated with shunt-responsive iNPH were identified using bivariate and multivariate analyses...
September 30, 2016: Journal of Neurosurgery
Marta Picascia, B Minafra, Roberta Zangaglia, L Gracardi, N G Pozzi, E Sinforiani, Claudio Pacchetti
Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by ventricular dilation accompanied by a progressive triad of a gait disturbance, "dementia" and incontinence. We retrospectively evaluated cognitive profile, and its relationship with disease variables, in 64 iNPH patients. The iNPH group performed significantly worse than the control group on all neuropsychological tests, except for verbal memory (within the normal range). The patients were subdivided into four groups: group 1 (42%: global cognitive impairment); group 2 (24%: frontosubcortical dysfunction); group 3 (17%: isolated deficit of a single cognitive domain); group 4 (17%: no cognitive impairment)...
July 2016: Functional Neurology
Stefan Schob, Donald Lobsien, Benjamin Friedrich, Matthias K Bernhard, Corinna Gebauer, Julia Dieckow, Matthias Gawlitza, Mandy Pirlich, Dorothee Saur, Lars Bräuer, Ingo Bechmann, Karl-Titus Hoffmann, Cynthia V Mahr, Ulf Nestler, Matthias Preuß
INTRODUCTION: Pulmonary Surfactant reduces surface tension in the terminal airways thus facilitating breathing and contributes to host's innate immunity. Surfactant Proteins (SP) A, B, C and D were recently identified as inherent proteins of the CNS. Aim of the study was to investigate cerebrospinal fluid (CSF) SP levels in hydrocephalus patients compared to normal subjects. PATIENTS AND METHODS: CSF SP A-D levels were quantified using commercially available ELISA kits in 126 patients (0-84 years, mean 39 years)...
2016: PloS One
Hiroaki Kazui, Hideki Kanemoto, Kenji Yoshiyama, Haruhiko Kishima, Yukiko Suzuki, Shunsuke Sato, Takashi Suehiro, Shingo Azuma, Toshiki Yoshimine, Toshihisa Tanaka
We examined the effect of the pathology of Alzheimer's disease (AD) on improvement of clinical symptoms after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). Forty-four iNPH patients were classified into 18 patients with (iNPH/AD+) and 26 patients without (iNPH/AD-) combination with low amyloid β42 and high total tau in cerebrospinal fluid (CSF). We compared improvements after lumbo-peritoneal shunt surgery (LPS) between the two groups in Timed Up & Go Test, 10-m reciprocating walking test, Digit Symbol Substitution Test, attention test, delayed recall test, Mini-Mental State Examination, iNPH grading scale, Neuropsychiatric Inventory, Zarit Burden Interview, and other evaluations...
October 15, 2016: Journal of the Neurological Sciences
A Junkkari, A Häyrinen, T Rauramaa, H Sintonen, O Nerg, A M Koivisto, R P Roine, H Viinamäki, H Soininen, A Luikku, J E Jääskeläinen, V Leinonen
BACKGROUND AND PURPOSE: This prospective study explored the factors affecting the health-related quality-of-life (HRQoL) outcome in patients with idiopathic normal-pressure hydrocephalus (iNPH) 1 year after the installation of the cerebrospinal fluid shunt. METHODS: The HRQoL outcome was evaluated using a 15D instrument, in which the minimum clinically significant change/difference has been estimated to be ±0.015. The follow-up data (15D, Mini-Mental State Examination, Beck Depression Inventory, iNPH Grading Scale), frontal cortical biopsy, Charlson Age Comorbidity Index and body mass index of 145 patients diagnosed with iNPH by clinical and radiological examination were analyzed...
September 19, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Ahmed K Toma, Laurence D Watkins
No abstract text is available yet for this article.
September 14, 2016: British Journal of Neurosurgery
Nina Sundström, Jan Malm, Katarina Laurell, Fredrik Lundin, Babar Kahlon, Kristina G Cesarini, Göran Leijon, Carsten Wikkelsö
OBJECT: To present population-based and age related incidence of surgery and clinical outcome for adult patients operated for hydrocephalus, registered in the Swedish Hydrocephalus Quality Registry (SHQR). METHODS: All patients registered in SHQR during 2004-2011 were included. Data on age, gender, type of hydrocephalus and type of surgery were extracted as well as three months outcome for patients with idiopathic normal pressure hydrocephalus (iNPH). RESULTS: The material consisted of 2360 patients, 1229 men and 1131 women, age 63...
September 13, 2016: British Journal of Neurosurgery
Sharif Vakili, Dane Moran, Alice Hung, Benjamin D Elder, Lee Jeon, Hugo Fialho, Eric W Sankey, Ignacio Jusué-Torres, C Rory Goodwin, Jennifer Lu, Jamie Robison, Daniele Rigamonti
OBJECTIVE A growing body of evidence suggests that longer durations of preoperative symptoms may correlate with worse postoperative outcomes following cerebrospinal fluid (CSF) diversion for treatment of idiopathic normal pressure hydrocephalus (iNPH). The aim of this study is to determine whether the duration of preoperative symptoms alters postoperative outcomes in patients treated for iNPH. METHODS The authors conducted a retrospective review of 393 cases of iNPH involving patients treated with ventriculoperitoneal (VP) shunting...
September 2016: Neurosurgical Focus
Ioannis Siasios, Eftychia Z Kapsalaki, Kostas N Fountas, Aggeliki Fotiadou, Alexander Dorsch, Kunal Vakharia, John Pollina, Vassilios Dimopoulos
OBJECTIVE Diffusion tensor imaging (DTI) for the assessment of fractional anisotropy (FA) and involving measurements of mean diffusivity (MD) and apparent diffusion coefficient (ADC) represents a novel, MRI-based, noninvasive technique that may delineate microstructural changes in cerebral white matter (WM). For example, DTI may be used for the diagnosis and differentiation of idiopathic normal pressure hydrocephalus (iNPH) from other neurodegenerative diseases with similar imaging findings and clinical symptoms and signs...
September 2016: Neurosurgical Focus
Alexander McGirr, Michael D Cusimano
No abstract text is available yet for this article.
September 15, 2016: Journal of the Neurological Sciences
Joel Huovinen, Sami Kastinen, Simo Komulainen, Minna Oinas, Cecilia Avellan, Janek Frantzen, Jaakko Rinne, Antti Ronkainen, Mikko Kauppinen, Kimmo Lönnrot, Markus Perola, Okko T Pyykkö, Anne M Koivisto, Anne M Remes, Hilkka Soininen, Mikko Hiltunen, Seppo Helisalmi, Mitja Kurki, Juha E Jääskeläinen, Ville Leinonen
Idiopathic normal pressure hydrocephalus (iNPH) is a late-onset surgically alleviated, progressive disease. We characterize a potential familial subgroup of iNPH in a nation-wide Finnish cohort of 375 shunt-operated iNPH-patients. The patients were questionnaired and phone-interviewed, whether they have relatives with either diagnosed iNPH or disease-related symptomatology. Then pedigrees of all families with more than one iNPH-case were drawn. Eighteen patients (4.8%) from 12 separate pedigrees had at least one shunt-operated relative whereas 42 patients (11%) had relatives with two or more triad symptoms...
September 15, 2016: Journal of the Neurological Sciences
Aravindhan Baheerathan, Devkishan Chauhan, Louis Koizia, Hugh O'Neal
No abstract text is available yet for this article.
2016: BMJ: British Medical Journal
Matthias Jaeger, Angela K Khoo, David A Conforti, Ramesh Cuganesan
Phase contrast cine MRI with determination of pulsatile aqueductal cerebrospinal fluid (CSF) stroke volume and flow velocity has been suggested to assess intracranial pulsations in idiopathic normal pressure hydrocephalus (iNPH). We aimed to compare this non-invasive measure of pulsations to intracranial pressure (ICP) pulse wave amplitude from continuous ICP monitoring. We hypothesised that a significant correlation between these two markers of intracranial pulsations exists. Fifteen patients with suspected iNPH had continuous computerised ICP monitoring with calculation of mean ICP pulse wave amplitude (MWA) from time-domain analysis...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Beatrice Arosio, Martina Casati, Cristina Gussago, Evelyn Ferri, Carlo Abbate, Valeria Scortichini, Elena Colombo, Paolo Dionigi Rossi, Daniela Mari
As the European population gets older, the incidence of neurological disorders increases with significant impact on social costs. Despite differences in disease etiology, several brain disorders in the elderly (e.g., Alzheimer's disease, vascular dementia, normal pressure hydrocephalus) share dementia as a common clinical feature. The current treatment for the majority of these diseases is merely symptomatic and does not modify the course of the illness. Symptoms of normal pressure hydrocephalus are the only ones that can be modified if they are recognized in time and treated appropriately...
September 6, 2016: Journal of Alzheimer's Disease: JAD
Sarah C Krzastek, William M Bruch, Samuel P Robinson, Harold F Young, Adam P Klausner
AIMS: The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH). METHODS: Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale...
August 4, 2016: Neurourology and Urodynamics
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