Document Detail

Does idiopathic normal pressure hydrocephalus always mean a poor prognosis?
MedLine Citation:
PMID:  19812929     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective was to assess whether idiopathic normal-pressure hydrocephalus (iNPH) has a worse prognosis than other forms of hydrocephalus, as has been suggested.
METHODS: A total of 125 patients with chronic hydrocephalus, 75 of whom suffered from iNPH and the remaining (non-INPH) from sNPH or non-communicating hydrocephalus, were shunted using gravitational valves. Clinical state was assessed with our clinical grading (KI) and a co-morbidity index (CMI). Average follow-up was 5.1 +/- 1.6 years.
STATISTICS: Spearman, Kruskal-Wallis, ANOVA, chi(2)- and the Wilcoxon U tests at a significance level of pi < 0.05 were used.
RESULTS: Shunt responder rates for iNPH and non-iNPH were 72% and 86%, respectively. With shorter anamnesis (< or =1 year) or preoperative KI < 6 points, iNPH patients had a similar or even better outcome than non-iNPH patients with longer anamnesis or a worse KI. Most impressive was the influence of co-morbidity: 86% of iNPH patients with a low CMI (< or =3 points) experienced clinical improvement after shunting, which was contrasted by a responder rate of 64% for non-iNPH with worse CMI.
CONCLUSION: The diagnosis of iNPH does not by itself mean a worse prognosis, and iNPH patients with favorable preconditions may have a similar or better prognosis than patients with any other kind of hydrocephalus. The worse overall clinical results of iNPH result from late recognition and in most instances worse preconditions.
Michael Kiefer; Ulrich Meier; Regina Eymann
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  106     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2010  
Date Detail:
Created Date:  2009-10-08     Completed Date:  2010-01-08     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  101-6     Citation Subset:  IM    
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MeSH Terms
Age Factors
Aged, 80 and over
Cerebrospinal Fluid Shunts / methods*
Disease Progression
Hydrocephalus, Normal Pressure / diagnosis*,  surgery*
Longitudinal Studies
Middle Aged
Severity of Illness Index
Time Factors
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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