scholarly journals Clinical Diagnosis and Treatment Management of Normal Pressure Hydrocephalus

2021 ◽  
Author(s):  
Hüseyin Yakar
Keyword(s):  
Quality Of Life ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Clinical Findings ◽  
Treatment Modalities ◽  
Arachnoid Granulation ◽  
Elderly Individuals ◽  
Clinical Triad ◽  
Unusual Appearance

Inadequate absorption of cerebrospinal fluid (CSF) at the arachnoid granulation level during circulation results in an increase in CSF in the ventricle and certain neuropsychiatric clinical findings. This syndrome, which often presents with ventricular dilatation, progressive cognitive decline, walking difficulties, and urinary incontinence symptoms in elderly individuals, is called Normal Pressure Hydrocephalus (NPH). It is projected that as people’s quality of life improves and their life expectancy rises, more old people would develop this condition. Although a clear clinical triad has been defined, the identification of patients with NPH and the application of effective treatment modalities still pose a number of challenges for neurosurgeons today. However, despite all these difficulties, if diagnosed and treated early, the unusual appearance of these symptoms affecting elderly individuals can be prevented and significant improvements in quality of life can be achieved.

Disability risk or unimproved symptoms following shunt surgery in patients with idiopathic normal-pressure hydrocephalus: post hoc analysis of SINPHONI-2

2016 ◽  
Vol 126 (6) ◽  
pp. 2002-2009 ◽  
Author(s):  
Shigeki Yamada ◽  
Teruo Kimura ◽  
Naoto Jingami ◽  
Masamichi Atsuchi ◽  
Osamu Hirai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Normal Pressure Hydrocephalus ◽  
Symptom Severity ◽  
Disease Duration ◽  
Normal Pressure ◽  
Gait Disturbance ◽  
Shunt Surgery ◽  
Tap Test ◽  
Relative Risks

OBJECTIVEThe study aim was to assess the influence of presurgical clinical symptom severity and disease duration on outcomes of shunt surgery in patients with idiopathic normal-pressure hydrocephalus (iNPH). The authors also evaluated the cerebrospinal fluid tap test as a predictor of improvements following shunt surgery.METHODSEighty-three patients (45 men and 38 women, mean age 76.4 years) underwent lumboperitoneal shunt surgery, and outcomes were evaluated until 12 months following surgery. Risks for poor quality of life (Score 3 or 4 on the modified Rankin Scale [mRS]) and severe gait disturbance were evaluated at 3 and 12 months following shunt surgery, and the tap test was also conducted. Age-adjusted and multivariate relative risks were calculated using Cox proportional-hazards regression.RESULTSOf 83 patients with iNPH, 45 (54%) improved by 1 point on the mRS and 6 patients (7%) improved by ≥ 2 points at 3 months following surgery. At 12 months after surgery, 39 patients (47%) improved by 1 point on the mRS and 13 patients (16%) improved by ≥ 2 points. On the gait domain of the iNPH grading scale (iNPHGS), 36 patients (43%) improved by 1 point and 13 patients (16%) improved by ≥ 2 points at 3 months following surgery. Additionally, 32 patients (38%) improved by 1 point and 14 patients (17%) by ≥ 2 points at 12 months following surgery. In contrast, 3 patients (4%) and 2 patients (2%) had worse symptoms according to the mRS or the gait domain of the iNPHGS, respectively, at 3 months following surgery, and 5 patients (6%) and 3 patients (4%) had worse mRS scores and gait domain scores, respectively, at 12 months after surgery. Patients with severe preoperative mRS scores had a 4.7 times higher multivariate relative risk (RR) for severe mRS scores at 12 months following surgery. Moreover, patients with severe gait disturbance prior to shunt surgery had a 46.5 times greater multivariate RR for severe gait disturbance at the 12-month follow-up. Patients without improved gait following the tap test had multivariate RRs for unimproved gait disturbance of 7.54 and 11.2 at 3 and 12 months following surgery, respectively. Disease duration from onset to shunt surgery was not significantly associated with postoperative symptom severity or unimproved symptoms.CONCLUSIONSPatients with iNPH should receive treatment before their symptoms become severe in order to achieve an improved quality of life. However, the progression of symptoms varies between patients so specific timeframes are not meaningful. The authors also found that tap test scores accurately predicted shunt efficacy. Therefore, indications for shunt surgery should be carefully assessed in each patient with iNPH, considering the relative risks and benefits for that person, including healthy life expectancy.

scholarly journals Surgical treatment of idiopathic normal pressure hydrocephalus (literature rewiew)

2019 ◽  
Vol 178 (2) ◽  
pp. 73-78
Author(s):  
G. V. Gavrilov ◽  
A. V. Stanishevskiy ◽  
B. V. Gaydar ◽  
D. V. Svistov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Normal Pressure Hydrocephalus ◽  
Surgical Intervention ◽  
Pathological Condition ◽  
Cognitive Disorders ◽  
Normal Pressure ◽  
Ventriculoperitoneal Shunting ◽  
Pump Valve

Normal pressure hydrocephalus is a pathological condition characterized by ventricular expansion in combination with normal intracranial pressure and manifested by a specific triad of symptoms, including gait disorders, cognitive disorders and urinary incontinence. The prevalence of the disease has not been fully studied and according to various population epidemiological researches reaches 0.3–3 % among  patients older than 61 years. A feature that differs normal pressure hydrocephalus from other neurodegenerative diseases is the possibility of full or partial regression of neurological symptoms after surgical treatment. The most common surgical intervention for normal pressure hydrocephalus is ventriculoperitoneal shunting. It is an implantation of a system of catheters connected by pump-valve into the patient’s body, that drainage cerebrospinal fluid from ventricles to abdomen cavity. Correct and timely surgical treatment of normal pressure hydrocephalus allows increasing the quality of life of patients with normal pressure hydrocephalus and, as a result, the quality of life of their relatives and friends.

scholarly journals Normal-Pressure Hydrocephalus, Sleep Apnea Syndrome, and Quality of Life in an Octagenarian

2016 ◽  
Vol 64 (9) ◽  
pp. 1922-1923 ◽  
Author(s):  
Jadwiga Attier-Zmudka ◽  
Jean-Marie Sérot ◽  
Youcef Douadi ◽  
Cyrille Capel ◽  
Roger Bouzerar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sleep Apnea ◽  
Normal Pressure Hydrocephalus ◽  
Sleep Apnea Syndrome ◽  
Normal Pressure ◽  
Apnea Syndrome

Cerebrospinal Fluid Shunting Improves Long-Term Quality of Life in Idiopathic Normal Pressure Hydrocephalus

Neurosurgery ◽  
2019 ◽  
Author(s):  
Hanna Israelsson ◽  
Anders Eklund ◽  
Jan Malm
Keyword(s):  
Quality Of Life ◽  
Cerebrospinal Fluid ◽  
Health Status ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Symptoms Of Depression ◽  
Cerebrospinal Fluid Shunting

Abstract BACKGROUND The short- and long-term impact of cerebrospinal fluid shunting on quality of life (QoL) in idiopathic normal pressure hydrocephalus (INPH) is poorly understood. OBJECTIVE To investigate QoL in shunted INPH patients compared to the population and to investigate which factors influence QoL in INPH. METHODS INPH patients consecutively shunted in Sweden during 2008-2010 were scrutinized. Population-based controls were age- and sex-matched to the patients. Included participants were the following: 176 INPH patients and 368 controls. QoL was assessed using the EuroQol 5-dimension 5-level (EQ5D5L) instrument, which measures overall QoL and health status in 5 dimensions. Independency (accommodation and/or need for in-home care) and comorbidities were assessed. Patients were followed up 6-45 mo after surgery (mean follow-up time: 21 mo). RESULTS Shunting improved QoL (P < .001) and health status in all dimensions (P < .005). Shunted INPH patients had lower QoL than controls (P < .001). The patients’ health status in mobility, self-care, daily activities, and anxiety/depression was worse than the controls both before and after surgery (P < .001). The main predictors of low QoL in INPH were symptoms of depression (P < .001) and severity of gait disturbance (P = .001). Fewer INPH patients than controls lived independently (45% vs 85%, P < .001). Time after shunting had no influence on QoL. CONCLUSION QoL remains improved in shunted INPH patients at a mean follow-up time of 21 mo, but the patients do not reach the same QoL as the population. Symptoms of depression and severity of gait disturbance are the strongest predictors of low QoL in INPH.

Health-related quality of life in patients with idiopathic normal pressure hydrocephalus

2015 ◽  
Vol 22 (10) ◽  
pp. 1391-1399 ◽  
Author(s):  
A. Junkkari ◽  
H. Sintonen ◽  
O. Nerg ◽  
A. M. Koivisto ◽  
R. P. Roine ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus

2014 ◽  
Vol 121 (4) ◽  
pp. 776-784 ◽  
Author(s):  
Jakob Petersen ◽  
Per Hellström ◽  
Carsten Wikkelsø ◽  
Åsa Lundgren-Nilsson
Keyword(s):  
Quality Of Life ◽  
Caregiver Burden ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Shunt Surgery ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Object To investigate the impact of shunt surgery on the activity, participation, autonomy, and health-related quality of life (HRQOL) of patients with idiopathic normal-pressure hydrocephalus (iNPH) as well as the effect on caregiver burden. Methods Thirty-seven patients (median age 70 years, range 50–89 years) with iNPH were evaluated before and 6 months after surgery. Symptoms and signs were assessed by the iNPH scale, activities of daily living (ADL) with the Functional Independence Measure (FIM) and Assessment of Motor and Process Skills (AMPS), autonomy and participation with Impact on Participation and Autonomy (IPA), and caregiver burden with the Caregiver Burden Scale (CBS). HRQOL was evaluated with the EQ-5D (EuroQol Group–5 Dimension health survey). Results Twenty-four patients (65%) improved clinically (iNPH scale score) and 31 (86%) improved their HRQOL after surgery, almost to the same level as found in the normal population. The patients became more independent in physical and cognitive activities, and participation and autonomy improved. The caregiver burden was decreased among caregivers to male patients but remained unchanged on the overall group level. Conclusions After shunt surgery, patients with iNPH showed improvement in most aspects of social life, they became more independent, and their quality of life returned to nearly normal.

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