Idiopathic normal pressure hydrocephalus

Idiopathic normal pressure hydrocephalus

J.Sales-Llopis

Neurosurgery Department, University General Hospital of Alicante, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), Alicante, Spain

Idiopathic Normal Pressure Hydrocephalus Definition.

see Idiopathic normal pressure hydrocephalus history.

Idiopathic Normal Pressure Hydrocephalus Epidemiology.

Idiopathic Normal Pressure Hydrocephalus Classification.

Idiopathic Normal Pressure Hydrocephalus Natural History

Idiopathic Normal Pressure Hydrocephalus Etiology.

see Idiopathic normal pressure hydrocephalus Pathogenesis.

see Idiopathic normal pressure hydrocephalus pathophysiology.

see Idiopathic normal pressure hydrocephalus clinical features.

see Idiopathic normal pressure hydrocephalus scales

see Idiopathic normal pressure hydrocephalus diagnosis

see Idiopathic normal pressure hydrocephalus differential diagnosis.

Idiopathic normal pressure hydrocephalus guidelines

see Idiopathic normal pressure hydrocephalus treatment.

see Idiopathic normal pressure hydrocephalus outcome.

see Idiopathic normal pressure hydrocephalus case series.

see Idiopathic normal pressure hydrocephalus case reports.

see Idiopathic normal pressure hydrocephalus experimental animal model.

Shunt for Idiopathic normal pressure hydrocephalus treatment

Shunt for Idiopathic normal pressure hydrocephalus treatment

• Early shunt surgery can significantly improve the clinical symptoms and prognosis of patients with idiopathic normal pressure hydrocephalus (iNPH). • Structural imaging findings have limited predictiveness for the prognosis of patients with iNPH after shunt surgery. • Patients should not be selected for shunt surgery based on only structural imaging findings 1).


Clinical decisions regarding Shunt for Idiopathic normal pressure hydrocephalus treatment should be individualized to each patient, with adequate consideration of the relative risks and benefits, including maximizing a healthy life expectancy 2).

see Ventriculoperitoneal shunt for idiopathic normal pressure hydrocephalus.

see Lumboperitoneal shunt for idiopathic normal pressure hydrocephalus.


1)

Chen J, He W, Zhang X, Lv M, Zhou X, Yang X, Wei H, Ma H, Li H, Xia J. Value of MRI-based semi-quantitative structural neuroimaging in predicting the prognosis of patients with idiopathic normal pressure hydrocephalus after shunt surgery. Eur Radiol. 2022 Apr 30. doi: 10.1007/s00330-022-08733-3. Epub ahead of print. PMID: 35501572.
2)

Nakajima M, Kuriyama N, Miyajima M, Ogino I, Akiba C, Kawamura K, Kurosawa M, Watanabe Y, Fukushima W, Mori E, Kato T, Sugano H, Tange Y, Karagiozov K, Arai H. Background Risk Factors Associated with Shunt Intervention for Possible Idiopathic Normal Pressure Hydrocephalus: A Nationwide Hospital-Based Survey in Japan. J Alzheimers Dis. 2019 Mar 11. doi: 10.3233/JAD-180955. [Epub ahead of print] PubMed PMID: 30883349.

Idiopathic normal pressure hydrocephalus MRI

Idiopathic normal pressure hydrocephalus MRI

see Evans index

see Callosal angle

see Cingulate sulcus sign

see DESH

NPH is characterized by an ongoing periventricular neuronal dysfunction seen on MRI as periventricular hyperintensity (PVH). Clinical improvement after shunt surgery is associated with CSF changes indicating a restitution of axonal function. Other biochemical effects of shunting may include increased monoaminergic and peptidergic neurotransmission, breakdown of blood brain barrier function, and gliosis 1).

An MRI-based diagnostic scheme used in a multicenter prospective study (Study of Idiopathic Normal Pressure Hydrocephalus on Neurological Improvement [SINPHONI]) appears to suggest that features of disproportionately enlarged subarachnoid-space hydrocephalus (DESH) are meaningful in the evaluation of NPH 2).

see Phase contrast magnetic resonance imaging for idiopathic normal pressure hydrocephalus.

Diffusion-weighted magnetic resonance imaging (DWI3) is used generally in the diagnosis and treatment of various neurodegenerative diseases. The apparent diffusion coefficient (ADC) of the brain, calculated from DWI data, is overestimated because of the effect of bulk motion (rigid body motion caused by the brain pulsation).

see Arterial spin labelled imaging for idiopathic normal pressure hydrocephalus.


1)

Tullberg M, Blennow K, Månsson JE, Fredman P, Tisell M, Wikkelsö C. Ventricular cerebrospinal fluid neurofilament protein levels decrease in parallel with white matter pathology after shunt surgery in normal pressure hydrocephalus. Eur J Neurol. 2007 Mar;14(3):248-54. PubMed PMID: 17355543.
2)

Hattori T, Ito K, Aoki S, Yuasa T, Sato R, Ishikawa M, et al: White matter alteration in idiopathic normal pressure hydrocephalus: tract-based spatial statistics study. AJNR Am J Neuroradiol 33:97–103, 2012
3)

Moseley ME, Cohen Y, Mintorovitch J, Chileuitt L, Shimizu H, Kucharczyk J, Wendland MF, Weinstein PR. Early detection of regional cerebral ischemia in cats: comparison of diffusion- and T2-weighted MRI and spectroscopy. Magn Reson Med. 1990 May;14(2):330-46. doi: 10.1002/mrm.1910140218. PMID: 2345513.
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