| Does idiopathic normal pressure hydrocephalus always mean a poor prognosis? | |
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MedLine Citation:
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PMID: 19812929 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Michael Kiefer; Ulrich Meier; Regina Eymann |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Acta neurochirurgica. Supplement Volume: 106 ISSN: 0065-1419 ISO Abbreviation: Acta Neurochir. Suppl. Publication Date: 2010 |
Date Detail:
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Created Date: 2009-10-08 Completed Date: 2010-01-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100962752 Medline TA: Acta Neurochir Suppl Country: Austria |
Other Details:
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Languages: eng Pagination: 101-6 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Saarland University Medical School, Homburg-Saar, Germany. Michael.Kiefer@uks.eu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Age Factors Aged Aged, 80 and over Cerebrospinal Fluid Shunts / methods* Disease Progression Female Humans Hydrocephalus, Normal Pressure / diagnosis*, surgery* Longitudinal Studies Male Middle Aged Severity of Illness Index Time Factors Treatment Outcome Young Adult |
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