4,072 results match your criteria Normal Pressure Hydrocephalus


Papilledema secondary to vestibular schwannoma: an atypical case without intracranial hypertension.

Neurochirurgie 2021 May 11. Epub 2021 May 11.

Service de Neurochirurgie, hôpital Pasteur 2, Nice, France; Université Côte d'Azur, Nice, France. Electronic address:

In most cases, vestibular schwannomas with papilledema are associated with intracranial hypertension secondary to hydrocephalus (obstructive or communicating). We describe the atypical case of a 39-years-old man who presented with bilateral papilledema revealing a vestibular schwannoma, but without hydrocephalus and with normal intracranial pressure. Ophtalmologic signs were completely resolved after tumor removal. Read More

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Lumbar and ventricular CSF concentrations of extracellular matrix proteins before and after shunt surgery in idiopathic normal pressure hydrocephalus.

Fluids Barriers CNS 2021 May 13;18(1):23. Epub 2021 May 13.

Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy At the University of Gothenburg, Sahlgrenska University Hospital/Mölndal, 431 80, Mölndal, Sweden.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a reversible CNS disease characterized by disturbed cerebrospinal fluid (CSF) dynamics. Changes in the extracellular matrix (ECM) composition might be involved in the pathophysiology of iNPH. The aim of this study was to explore possible differences between lumbar and ventricular CSF concentrations of the ECM markers brevican and neurocan, matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase-1 (TIMP-1) and their relation to clinical symptoms in iNPH patients before and after shunt surgery. Read More

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Serial Tap Test of patients with idiopathic normal pressure hydrocephalus: impact on cognitive function and its meaning.

Fluids Barriers CNS 2021 May 6;18(1):22. Epub 2021 May 6.

Neurology Service, Internal Medicine Department, Hospital Clinics, Federal University of Paraná, Curitiba, Paraná, Brazil.

Background: Idiopathic normal pressure hydrocephalus (INPH) is characterized by gait disturbance, urinary incontinence and cognitive decline. Symptoms are potentially reversible and treatment is based on cerebrospinal fluid shunting. The tap test (TT) is used to identify patients that will benefit from surgery. Read More

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Fully Automated Segmentation of Head CT Neuroanatomy Using Deep Learning.

Radiol Artif Intell 2020 Sep 30;2(5):e190183. Epub 2020 Sep 30.

Departments of Radiology (J.C.C., K.A.P., S.H., P.R., G.M.C., D.C.V., Q.H., B.J.E.) and Cardiovascular Science (Z.A.), Mayo Clinic Rochester, 200 First St. SW, RO_PB_02_RIL, Rochester, MN 55905; Department of Radiology, Khon Kaen University, Khon Kaen, Thailand (A.B.); Department of Health Sciences Research, Mayo Clinic Florida, Jacksonville, Fla (A.D.W.); and Department of Internal Medicine, Ascension St. John Hospital, Detroit, Mich (A.Z.).

Purpose: To develop a deep learning model that segments intracranial structures on head CT scans.

Materials And Methods: In this retrospective study, a primary dataset containing 62 normal noncontrast head CT scans from 62 patients (mean age, 73 years; age range, 27-95 years) acquired between August and December 2018 was used for model development. Eleven intracranial structures were manually annotated on the axial oblique series. Read More

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September 2020

Leptomeningeal Carcinomatosis With Optic Nerve Metastasis Secondary to Breast Cancer.

Cureus 2021 Mar 31;13(3):e14200. Epub 2021 Mar 31.

Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.

Leptomeningeal carcinomatosis (LC) and optic nerve metastasis are uncommon occurrences in breast cancer. We report a rare case of LC with optic nerve infiltration secondary to breast cancer. A 45-year-old lady who was a known case of treated right breast carcinoma six years ago presented with a blurring of vision in both eyes, floaters, and diplopia for one month. Read More

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Pearls & Oy-sters: Idiopathic Normal Pressure Hydrocephalus With Synucleinopathy: Diagnosis and Treatment.

Neurology 2021 Apr 30. Epub 2021 Apr 30.

Sang-Won Han, MD, Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea; Young Ho Park, MD, PhD, Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea; Nayoung Ryoo, MD, Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea; Kitae Kim, MD, Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea; Jung-Min Pyun, MD, Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea; SangYun Kim, MD, PhD, Department of Neurology, Seoul National University College of Medicine and Seoul National University Bundang Hospital, Republic of Korea.

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Transversus abdominis plane block for lumboperitoneal shunt surgery in idiopathic normal pressure hydrocephalus: a case report.

J Surg Case Rep 2021 Apr 19;2021(4):rjab123. Epub 2021 Apr 19.

Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

The transversus abdominis plane (TAP) block is an ideal pain control method used in surgeries that require abdominal wall incisions through the injection of an anesthetic solution into the plane between the internal oblique muscle and transversus abdominis muscle. Herein, we report an 83-year-old man who was diagnosed with idiopathic normal pressure hydrocephalus (iNPH) and underwent lumboperitoneal shunt surgery (LPS). The TAP block was performed before LPS, and the numerical rating scale for pain was 0 at day 1 after the surgery. Read More

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Hydrocephalic Dementia: Revisited with Multimodality Imaging and toward a Unified Imaging Approach.

J Neurosci Rural Pract 2021 Apr 23;12(2):412-418. Epub 2021 Apr 23.

Division of Neuroradiology, Department of Neuroimaging and interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India.

 Overlap of normal pressure hydrocephalus (NPH) and pathology proven cases of dementia is known. The objective of this paper is to correlate both the clinical and multimodality imaging findings in patients with imaging diagnosis NPH and give a hypothesis for association of clinical findings.  This is a retrospective observational analysis of 13 cases patients who were referred to molecular imaging center for imaging in 2016 to 2019, and they were divided into four groups based on structural imaging findings. Read More

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CSF Dynamics for Shunt Prognostication and Revision in Normal Pressure Hydrocephalus.

J Clin Med 2021 Apr 15;10(8). Epub 2021 Apr 15.

Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK.

Background: Despite the quantitative information derived from testing of the CSF circulation, there is still no consensus on what the best approach could be in defining criteria for shunting and predicting response to CSF diversion in normal pressure hydrocephalus (NPH).

Objective: We aimed to review the lessons learned from assessment of CSF dynamics in our center and summarize our findings to date. We have focused on reporting the objective perspective of CSF dynamics testing, without further inferences to individual patient management. Read More

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Feasibility of action observation effect on gait and mobility in idiopathic normal pressure hydrocephalus patients.

Dement Neuropsychol 2021 Jan-Mar;15(1):79-87

Faculty of Physical Therapy, Mahidol University - Nakhon Pathom, Thailand.

Action observation (AO) has been proved to be of benefit in several neurological conditions, but no study has previously been conducted in idiopathic normal pressure hydrocephalus (iNPH).

Objective: This study aimed to investigate the feasibility of AO in iNPH patients.

Methods: A single-group pretest-posttest design was conducted in twenty-seven iNPH patients. Read More

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Unusual side effects of levetiracetam.

BMJ Case Rep 2021 Apr 26;14(4). Epub 2021 Apr 26.

Department of Neurology, Galilee Medical Center, Nahariya, Israel.

We present a 75-year-old man who was admitted to our hospital due to 4 months of general deterioration, gait disturbance and cognition impairment which appeared very close to the start of levetiracetam (LEV) as a new antiepileptic drug. Brain CT shows central and less peripheral atrophy of brain, and diagnosis of normal pressure hydrocephalus was raised; however, removal of 30 cc of cerebrospinal fluid (CSF) by lumbar puncture in order to amend walking did not lead to gait improvement. After excluding metabolic, vascular, infection, inflammatory and other reasons explaining his status. Read More

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Screening for idiopathic normal pressure hydrocephalus in the elderly after falls.

Clin Neurol Neurosurg 2021 Apr 24;205:106635. Epub 2021 Apr 24.

Department of Neurosurgery, Tokai University, Kanagawa, Japan.

Objective: Many patients with idiopathic normal pressure hydrocephalus (iNPH) have reportedly fallen prior to diagnosis. However, there are no previous reports on the iNPH prevalence among the elderly with history of falls. This study investigated the effectiveness of screening for iNPH in elderly patients presenting after a fall. Read More

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The CERAD Neuropsychological Battery in Patients with Idiopathic Normal Pressure Hydrocephalus Compared with Normal Population and Patients with Mild Alzheimer's Disease.

J Alzheimers Dis 2021 Apr 21. Epub 2021 Apr 21.

Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland.

Background: The usefulness of CERAD Neuropsychological Battery for describing the cognitive impairment in idiopathic normal pressure hydrocephalus (iNPH) is unknown.

Objective: To compare the cognitive profile of patients with iNPH to patients with mild Alzheimer's disease (AD) and age-matched cognitively healthy individuals by using the CERAD-NB.

Methods: We studied CERAD-NB subtest results, including the Mini-Mental State Examination (MMSE), between 199 patients with probable iNPH, 236 patients with mild AD, and 309 people with normal cognition, using age, education, and gender adjusted multivariate linear regression model. Read More

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Preoperative Predictive Factors of Short-Term Outcome in Idiopathic Normal Pressure Hydrocephalus (iNPH).

World Neurosurg 2021 Apr 22. Epub 2021 Apr 22.

Department of Neurosurgery, Nayoro General Hospital, Nayoro City, Japan.

Background: Surgical treatment of iNPH by ventriculoperitoneal (VP) or lumboperitoneal (LP) shunting can achieve long-term recovery of activities of daily living (ADLs), however in a subset of patients maintenance of independence lasts for less than six months. This study METHODS: Over a 9-year period, consecutive patients from multiple centers diagnosed with probable iNPH underwent either VP or LP shunt surgery. Preoperative variables of age, symptom duration, iNPH severity, tap test response, and MRI findings of disproportionately enlarged subarachnoid space hydrocephalus (DESH) or incomplete DESH were retrospectively evaluated in relation to 1-year postoperative outcome. Read More

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[Options for the symptomatic treatment of chronic neurological gait disorders].

Fortschr Neurol Psychiatr 2021 Apr 23. Epub 2021 Apr 23.

Ludwig-Maximilians-Universität München, Medizinische Fakultät, Department of Neurology; Ludwig-Maximilians-Universität München, Medizinische Fakultät, German Center for Vertigo and Balance Disorders.

Gait and mobility impairments are common and relevant in patients with chronic neurological disorders. It reduces the health-related quality of life and induces falls with morbidity. Symptomatic treatment options are therefore necessary in order to improve the health status of patients with neurological disorders. Read More

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Corpus Callosum Hyperintensity in Normal Pressure Hydrocephalus After Ventriculoperitoneal Shunt.

Neurology 2021 Apr 23. Epub 2021 Apr 23.

Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, Ontario, Canada. Division of Neurology, University of Toronto, Toronto, Ontario, Canada

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Clinical Outcome and Striatal Dopaminergic Function After Shunt Surgery in Patients With Idiopathic Normal Pressure Hydrocephalus.

Neurology 2021 Apr 23. Epub 2021 Apr 23.

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy

Objective: To determine changes in clinical features and striatal dopamine reuptake transporter (DAT) density after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH).

Methods: Subjects with probable iNPH were assessed at baseline by means of clinical rating scales, brain MRI, and SPECT with [I]-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (FP-CIT). Levodopa responsiveness was also evaluated. Read More

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Variability of Normal Pressure Hydrocephalus Imaging Biomarkers with Respect to Section Plane Angulation: How Wrong a Radiologist Can Be?

AJNR Am J Neuroradiol 2021 Apr 22. Epub 2021 Apr 22.

Imaging and Functional Medicine (J.Z.), University Hospital of Umeå, Umeå, Sweden

Background And Purpose: Systematic analysis of angulation-related variability of idiopathic normal pressure hydrocephalus imaging biomarkers has not been published yet. Our aim was to evaluate the variability of these radiologic biomarkers with respect to imaging plane angulation.

Materials And Methods: Eighty subjects (35 with clinically confirmed idiopathic normal pressure hydrocephalus and 45 age- and sex-matched healthy controls) were prospectively enrolled in a 3T brain MR imaging study. Read More

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Ventriculomegaly in children: nocturnal ICP dynamics identify pressure-compensated but active paediatric hydrocephalus.

Childs Nerv Syst 2021 Apr 22. Epub 2021 Apr 22.

Section of Paediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tübingen, Tübingen, Germany.

Introduction: Paediatric ventriculomegaly without obvious signs or symptoms of raised intracranial pressure (ICP) is often interpreted as resulting from either relative brain atrophy, arrested "benign" hydrocephalus, or "successful" endoscopic third ventriculostomy (ETV). We hypothesise that the typical ICP "signature" found in symptomatic hydrocephalus can be present in asymptomatic or oligosymptomatic children, indicating pressure-compensated, but active hydrocephalus.

Methods: A total of 37 children fulfilling the mentioned criteria underwent computerised ICP overnight monitoring (ONM). Read More

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Clinical significance of vitamin D in idiopathic normal pressure hydrocephalus.

Acta Neurochir (Wien) 2021 Apr 21. Epub 2021 Apr 21.

Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Background: Although recent studies show vitamin D deficiency is associated with cognitive decline, urinary incontinence, and gait instability, there has been no study on the effect of vitamin D on idiopathic normal pressure hydrocephalus (iNPH) characterized by the classic symptom triad of cognitive decline, urinary incontinence, and gait instability. We investigated the clinical significance of vitamin D in patients with iNPH.

Methods: Between 2017 and 2020, 44 patients who underwent ventriculoperitoneal shunt surgery were divided into low (< 15 ng/mL) and high (≥ 15 ng/mL) vitamin D groups according to the concentration of 25(OH)D, an effective indicator of vitamin D status. Read More

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[Cognitive and gait dysfunction in the elderly caused by age-related cerebral small vessel disease and idiopathic normal pressure hydrocephalus: a case series of three patients].

Zhonghua Yi Xue Za Zhi 2021 Apr;101(15):1093-1096

Department of Neurology, the First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou 510080, China.

Three cases with age-related cerebral small vessel disease and normal pressure hydrocephalus in the Department of Neurology of Sun Yat-sen University were retrospectively reviewed. All the patients exhibited gait disturbance, cognitive impairment and urinary incontinence. Meanwhile, the Craniocerebral imaging demonstrated cerebral small vessel disease and communicating hydrocephalus. Read More

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Prognostic value of the pulse pressure amplitudes, time to reach the plateau and the slope obtained in the lumbar infusion test for the study of idiophatic normal pressure hydrocephalus.

Neurocirugia (Astur) 2021 Apr 16. Epub 2021 Apr 16.

Servicio de Neurocirugía, Complejo Asistencial Universitario de Salamanca, Salamanca, España.

Background And Objective: To study the prognostic value of the resistance to the cerebrospinal fluid outflow (Rout) obtained in the lumbar infusion test in idiopathic normal pressure hydrocephalus (iNPH), as well as the pulse pressure amplitudes in the different periods of the test and other new variables extracted by Neuropicture® software.

Material And Methods: Patients with ́probable iNPH́ who underwent a lumbar infusion test were retrospectively revised. The positive predictive values (PPV) of the cutoff point of the best prognostic accuracy of the Rout, the basal pulse pressure amplitude (AMP0), the pulse pressure amplitude during the first 10minutes (AMP), the plateau pulse pressure amplitude (AMPmes), the Rout pulse pressure amplitude (AMP), the time to reach the plateau (T), and the slope until reaching the plateau were determined. Read More

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Exploring mechanisms of ventricular enlargement in idiopathic normal pressure hydrocephalus: a role of cerebrospinal fluid dynamics and motile cilia.

Fluids Barriers CNS 2021 Apr 19;18(1):20. Epub 2021 Apr 19.

Department of Neurosurgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.

Idiopathic normal pressure hydrocephalus (iNPH) is considered an age-dependent chronic communicating hydrocephalus associated with cerebrospinal fluid (CSF) malabsorption; however, the aetiology of ventricular enlargement in iNPH has not yet been elucidated. There is accumulating evidence that support the hypothesis that various alterations in CSF dynamics contribute to ventricle dilatation in iNPH. This review focuses on CSF dynamics associated with ventriculomegaly and summarises the current literature based on three potential aetiology factors: genetic, environmental and hydrodynamic. Read More

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Patient Risk Factors Associated with 30- and 90- Day Readmission after Ventriculoperitoneal Shunt Placement for Idiopathic Normal Pressure Hydrocephalus in Elderly Patients: A Nationwide Readmission Study.

World Neurosurg 2021 Apr 13. Epub 2021 Apr 13.

Department of Neurosurgery, Yale University School of Medicine, New Haven, CT; Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, CT. Electronic address:

Objective: For idiopathic normal pressure hydrocephalus (iNPH), risk stratifying patients and identifying those who are likely to fare well after ventriculoperitoneal shunt (VP) surgery may help improve quality of care and reduce unplanned readmissions. The aim of this study was to investigate the drivers of 30- and 90-day readmissions following VP shunt surgery for iNPH in elderly patients.

Methods: The Nationwide Readmission Database years 2013 - 2015 was queried. Read More

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The topology of ventricle surfaces and its application in the analysis of hydrocephalic ventricles: a proof-of-concept study.

Neuroradiology 2021 Apr 15. Epub 2021 Apr 15.

Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.

Purpose: The cerebral ventricles deform in a non-uniform fashion in response to increased CSF volume and/or pressure in hydrocephalic syndromes. Current research is focused on volumetric analyses, while topological analysis of ventricular surfaces remains understudied. We developed a method of quantitatively modeling the curvature of ventricular surfaces to analyze changes in ventricular surfaces in normal pressure hydrocephalus (NPH) and Alzheimer's disease (AD), using the left frontal horn as an example. Read More

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The "Brain Stethoscope": A Non-Invasive Method for Detecting Elevated Intracranial Pressure.

Cureus 2021 Mar 13;13(3):e13865. Epub 2021 Mar 13.

Mechanical and Aerospace Engineering, University of Central Florida, Orlando, USA.

Introduction Minimally invasive intracranial pressure (ICP) screening has long been desired by neurosurgeons. A novel approach deriving ICP from tympanic membrane (TM) pulsation may offer the solution. The ICP waveform appears to be transmitted to the TM by the cochlear aqueduct. Read More

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Compliance of the cerebrospinal space: comparison of three methods.

Acta Neurochir (Wien) 2021 Apr 14. Epub 2021 Apr 14.

Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.

Background: Cerebrospinal compliance describes the ability of the cerebrospinal space to buffer changes in volume. Diminished compliance is associated with increased risk of potentially threatening increases in intracranial pressure (ICP) when changes in cerebrospinal volume occur. However, despite various methods of estimation proposed so far, compliance is seldom used in clinical practice. Read More

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