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Review
. 2014 Nov;29(7):583-9.
doi: 10.1177/1533317514523485. Epub 2014 Feb 18.

Diagnosis and prognosis in idiopathic normal pressure hydrocephalus

Sayantani Ghosh  1 , Carol Lippa  2
Affiliations
Review

Diagnosis and prognosis in idiopathic normal pressure hydrocephalus

Sayantani Ghosh et al. Am J Alzheimers Dis Other Demen. 2014 Nov.

Abstract

Idiopathic normal pressure hydrocephalus (iNPH) is a communicating hydrocephalus, of unknown pathophysiology, characterized by the classical triad of dementia, urinary incontinence, and ataxia. The most popular treatment option is shunt surgery, although it is not a cure. The diagnosis of the disorder is challenging as it may mimic a lot of other neurological conditions and has no distinct biomarker. It becomes even more challenging as majority of the cases are diagnosed by invasive cerebrospinal fluid (CSF) removal tests. However, a careful history taking, a keen and detailed physical examination, and pertinent imaging studies can lead to an early diagnosis. The gait symptoms respond the most to surgery. The predictors deciding the postsurgical prognosis has been discussed. Improved shunting modalities and novel shunt materials with valve adjustments have improved the precision of the shunting procedures. Still we have lot more to achieve in terms of early diagnosis and definitive management of iNPH.

Keywords: LP shunt; VP shunt; biomarker; idiopathic normal pressure hydrocephalus; imaging; prognosis.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005;57(3 suppl):S4–S16. - PubMed
    1. Adams RD, Fisher CM, Hakim S, OJEMANN RG, SWEET WH. Symptomatic occult hydrocephalus with “normal” cerebrospinal-fluid pressure. A treatable syndrome. N Engl J Med. 1965;273:117–126. - PubMed
    1. Krauss JK, Halve B. Normal pressure hydrocephalus: survey on contemporary diagnostic algorithms and therapeutic decision-making in clinical practice. Acta Neurochir (Wien). 2004;146(4):379–388. - PubMed
    1. Tisell M, Höglund M, Wikkelsø C. National and regional incidence of surgery for adult hydrocephalus in Sweden. Acta Neurol Scand. 2005;112(2):72–75. - PubMed
    1. Klassen BT, Ahlskog JE. Normal pressure hydrocephalus: how often does the diagnosis hold water? Neurology. 2011;77(12):1119–1125. - PMC - PubMed

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