3,831 results match your criteria Normal Pressure Hydrocephalus


Prevalence of Alternative Diagnoses and Implications for Management in Idiopathic Normal Pressure Hydrocephalus Patients.

Neurosurgery 2020 May 30. Epub 2020 May 30.

Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan.

Background: Following Bayes theorem, ventriculomegaly and ataxia confer only a 30% chance of idiopathic Normal Pressure Hydrocephalus (NPH). When coupled with positive responses to best diagnostic testing (extended lumbar drainage), 70% of patients recommended for shunting will not actually have NPH. This is inadequate clinical care. Read More

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http://dx.doi.org/10.1093/neuros/nyaa199DOI Listing

Commentary: Prevalence of Alternative Diagnoses and Implications for Management in Idiopathic Normal Pressure Hydrocephalus Patients.

Neurosurgery 2020 May 29. Epub 2020 May 29.

J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

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http://dx.doi.org/10.1093/neuros/nyaa218DOI Listing

Progressive Parkinsonism Three Years after Shunt Surgery in a Patient with Idiopathic Normal Pressure Hydrocephalus.

Intern Med 2020 May 26. Epub 2020 May 26.

Shimada Hospital, Japan.

An 86-year-old man, who had undergone a lumboperitoneal shunt for idiopathic normal pressure hydrocephalus (iNPH) implanted 4 years earlier showed progressive parkinsonism for the past year. His clinical symptoms, including resting tremor and rapid eye movement sleep behavior disorder, responsiveness to levodopa, and abnormal findings on I-MIBG myocardial scintigraphy and dopamine transporter imaging, indicated that his pathological background of parkinsonism included concomitant synucleinopathy, such as Parkinson's disease or dementia with Lewy bodies, in addition to iNPH. Clinicians should consider the possibility of concomitant proteinopathies and their treatments when clinical symptoms become evident after shunt operations in patients with iNPH. Read More

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http://dx.doi.org/10.2169/internalmedicine.4553-20DOI Listing

Spontaneous Migration of a Ventriculoperitoneal Shunt into the Venous System: A Multidisciplinary Approach.

Cureus 2020 Apr 22;12(4):e7779. Epub 2020 Apr 22.

Neurointerventional Radiology and Surgery, OSF St. Joseph Medical Center - OSF Healthcare, Bloomington, USA.

Ventriculoperitoneal shunt catheter migration is a rare but documented complication. The exact mechanism of this occurrence is not well understood. We report the case of an 81-year-old male who initially presented with symptoms consistent with normal pressure hydrocephalus. Read More

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http://dx.doi.org/10.7759/cureus.7779DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243621PMC

Novel, clinically applicable, method to measure step-width during the swing phase of gait.

Physiol Meas 2020 May 22. Epub 2020 May 22.

Biomedical Engineering, Umea University Department of Radiation Sciences, Umea, SWEDEN.

Objective: Step-width during walking is an indicator of stability and balance in patients with neurological disorders, and development of objective tools to measure this clinically would be a great advantage. The aim of this study was to validate an in-house developed gait analysis system (Striton), based on optical and inertial sensors and a novel method for stride detection, for measuring step-width during the swing phase of gait and temporal parameters.

Approach: The step-width and stride-time measurements were validated in an experimental setup, against a 3D motion capture system and on an instrumented walkway. Read More

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http://dx.doi.org/10.1088/1361-6579/ab95edDOI Listing

Most Small Cerebral Cortical Veins Demonstrate Significant Flow Pulsatility: A Human Phase Contrast MRI Study at 7T.

Front Neurosci 2020 5;14:415. Epub 2020 May 5.

Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom.

Phase contrast MRI (pcMRI) has been used to investigate flow pulsatility in cerebral arteries, larger cerebral veins, and the cerebrospinal fluid (CSF). Such measurements of intracranial pulsatility and compliance are beginning to inform understanding of the pathophysiology of conditions including normal pressure hydrocephalus, multiple sclerosis, and dementias. We demonstrate the presence of flow pulsatility in small cerebral cortical veins, for the first time using pcMRI at 7 T, with the aim of improving our understanding of the hemodynamics of this little-studied vascular compartment. Read More

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http://dx.doi.org/10.3389/fnins.2020.00415DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214844PMC

Frontal Behavior Syndromes in Idiopathic Normal Pressure Hydrocephalus as a Function of Alzheimer's Disease Biomarker Status.

J Int Neuropsychol Soc 2020 May 20:1-11. Epub 2020 May 20.

Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI.

Objectives: Cognitive impairment and apathy are well-documented features of idiopathic normal pressure hydrocephalus (iNPH). However, research examining other neuropsychiatric manifestations of iNPH is scant, and it is unknown whether the neuropsychiatric presentation differs for iNPH patients with comorbid Alzheimer's disease (AD) versus iNPH without AD. This study aims to advance our understanding of neuropsychiatric syndromes associated with iNPH. Read More

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http://dx.doi.org/10.1017/S1355617720000387DOI Listing

Considerations for Patients With Idiopathic Normal Pressure Hydrocephalus Undergoing Cardiac Surgery.

Authors:
Halil Onder

J Cardiothorac Vasc Anesth 2020 Apr 10. Epub 2020 Apr 10.

Neurology Clinic, Yozgat City Hospital, Yozgat, Turkey.

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http://dx.doi.org/10.1053/j.jvca.2020.03.027DOI Listing

Progressive supranuclear palsy often develops idiopathic normal pressure hydrocephalus-like MRI features.

Eur J Neurol 2020 May 16. Epub 2020 May 16.

Department of Neurology and Neurological Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a clinical entity without established pathological hallmarks. Previous autopsy studies reported that patients with an ante-mortem diagnosis of iNPH had different post-mortem diagnosis, commonly progressive supranuclear palsy (PSP). Disproportionately enlarged subarachnoid space hydrocephalus (DESH) has been reported as a characteristic feature of iNPH on magnetic resonance imaging (MRI). Read More

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http://dx.doi.org/10.1111/ene.14322DOI Listing

[Diagnosis and treatment of normal pressure hydrocephalus].

Ugeskr Laeger 2020 May;182(19)

This review summarises the current knowledge of normal pressure hydrocephalus (NPH), which is considered to be a reversible cause of dementia. Early identification is important to select patients for surgical treatment with ventricular shunting. The symptoms of NPH are gait disturbance, cognitive dysfunction and urinary incontinence. Read More

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Magnetic Resonance Imaging Biomarkers Distinguish Normal Pressure Hydrocephalus From Progressive Supranuclear Palsy.

Mov Disord 2020 May 12. Epub 2020 May 12.

Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy.

Background: Idiopathic normal pressure hydrocephalus and PSP share several clinical and radiological features, making differential diagnosis, at times, challenging.

Objectives: To differentiate idiopathic normal pressure hydrocephalus from PSP using MR volumetric and linear measurements.

Methods: Twenty-seven idiopathic normal pressure hydrocephalus patients, 103 probable PSP patients, and 43 control subjects were consecutively enrolled. Read More

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http://dx.doi.org/10.1002/mds.28087DOI Listing

Cerebrospinal Fluid Biomarkers to Differentiate Idiopathic Normal Pressure Hydrocephalus from Subcortical Ischemic Vascular Disease.

J Alzheimers Dis 2020 May 4. Epub 2020 May 4.

Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark.

Background: Idiopathic normal pressure hydrocephalus (iNPH) remains a challenge to differentiate from subcortical ischemic vascular disease (SIVD). Despite major research efforts, the cerebrospinal fluid (CSF) biomarker profiles of the two diseases are still not known in detail.

Objective: To determine if novel CSF biomarkers, neurofilament light (NFL) reflecting axonal damage, the synaptic protein neurogranin (NG), and the astroglial marker chitinase-3-like protein 1 (YKL-40), and the core Alzheimer's disease (AD) biomarkers, amyloid-β 42 (Aβ42), total tau (t-tau), phosphorylated tau (p-tau), can differentiate iNPH from SIVD. Read More

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http://dx.doi.org/10.3233/JAD-200036DOI Listing

Intracerebral hematoma at the basal ganglia following lumbar puncture.

J Stroke Cerebrovasc Dis 2020 May 7:104847. Epub 2020 May 7.

Department of Neurology, University of Health Sciences, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.

Background: In patients with normal pressure hydrocephalus (NPH), lumbar puncture (LP) is an effective method for assessing both the diagnosis as well as the possible efficacy of ventriculoperitoneal shunting based on symptom improvement. However, it should be considered that there exists a low risk of complications and that these risks may result in morbidity and mortality. We present a patient who developed hematoma in the basal ganglia following LP. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104847DOI Listing

Cerebral Perfusion Does Not Increase after Shunt Surgery for Normal Pressure Hydrocephalus.

J Neuroimaging 2020 May 6;30(3):303-307. Epub 2020 May 6.

Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.

Background And Purpose: Cerebral blood flow (CBF) has been reported to increase after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). The aims of this study were to investigate if CBF, measured using the noninvasive perfusion MRI method arterial spin labeling (ASL), increased after shunt surgery, if postoperative change in CBF correlated with improvement in symptoms, and if baseline CBF data correlated with postoperative outcome.

Methods: Twenty-three patients with iNPH were prospectively included and examined with MRI of the brain and clinical tests of symptoms at baseline. Read More

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http://dx.doi.org/10.1111/jon.12702DOI Listing

Lumboperitoneal shunt in idiopathic normal pressure hydrocephalus: a prospective controlled study.

J Neurol 2020 May 5. Epub 2020 May 5.

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy.

Objective: In this prospective, controlled, monocentric study, we described the clinical and neuroimaging 12-month follow-up of two parallel cohorts of subjects with idiopathic normal pressure hydrocephalus (iNPH), who did or did not undergo lumboperitoneal shunt (LPS).

Methods: We recruited 78 iNPH patients. At baseline, subjects underwent clinical and neuropsychological assessments, 3 T magnetic resonance imaging (MRI), and tap test. Read More

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http://dx.doi.org/10.1007/s00415-020-09844-xDOI Listing

A venous mechanism of ventriculomegaly shared between traumatic brain injury and normal ageing.

Brain 2020 May 6. Epub 2020 May 6.

Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Recently, age-related timing dissociation between the superficial and deep venous systems has been observed; this was particularly pronounced in patients with normal pressure hydrocephalus, suggesting a common mechanism of ventriculomegaly. Establishing the relationship between venous drainage and ventricular enlargement would be clinically relevant and could provide insight into the mechanisms underlying brain ageing. To investigate a possible link between venous drainage and ventriculomegaly in both normal ageing and pathological conditions, we compared 225 healthy subjects (137 males and 88 females) and 71 traumatic brain injury patients of varying ages (53 males and 18 females) using MRI-based volumetry and a novel perfusion-timing analysis. Read More

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http://dx.doi.org/10.1093/brain/awaa125DOI Listing

Role of psychiatric, cardiovascular, socioeconomic, and demographic risk factors on idiopathic normal pressure hydrocephalus: A retrospective case-control study.

Clin Neurol Neurosurg 2020 Jun 28;193:105836. Epub 2020 Apr 28.

University of Hawai'i at Mānoa, John A. Burns School of Medicine, Honolulu, Hawai'i, USA; Hawaii Pacific Neuroscience, Honolulu, Hawai'i, USA.

Objectives: Currently, predicting and preventing idiopathic normal pressure hydrocephalus (iNPH) remains challenging, especially for patients without a history of cerebrovascular disease. By exploring the role of cardiovascular and psychiatric history, demographics, and socioeconomic status in iNPH, will provide better direction for elucidating the etiology or addressing healthcare inequalities.

Patients And Methods: To investigate iNPH with respect to the selected risk factors, we conducted a retrospective case-control study from a neuroscience institute in Hawaii with a patient pool of 25,843. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105836DOI Listing

ACR Appropriateness Criteria® Dementia.

J Am Coll Radiol 2020 May;17(5S):S100-S112

Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia.

Degenerative disease of the central nervous system is a growing public health concern. The primary role of neuroimaging in the workup of patients with probable or possible Alzheimer disease has typically been to exclude other significant intracranial abnormalities. In general, the imaging findings in structural studies, such as MRI, are nonspecific and have limited potential in differentiating different types of dementia. Read More

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http://dx.doi.org/10.1016/j.jacr.2020.01.040DOI Listing
May 2020
2.283 Impact Factor

iNPH as a '2-hit' Intracranial Hydrodynamic Derangement Disease.

Trends Mol Med 2020 Jun 25;26(6):531-532. Epub 2020 Apr 25.

Careggi University Hospital, Florence, Italy; Department of Clinical and Experimental Biomedical Sciences 'Mario Serio' University of Florence, Florence, Italy. Electronic address:

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http://dx.doi.org/10.1016/j.molmed.2020.04.002DOI Listing

Poroelastic Mechanical Properties of the Brain Tissue of Normal Pressure Hydrocephalus Patients During Lumbar Drain Treatment Using Intrinsic Actuation MR Elastography.

Acad Radiol 2020 Apr 21. Epub 2020 Apr 21.

Thayer School of Engineering, Dartmouth College, 14 Engineering Dr, Hanover, NH 03755; Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.

Rationale And Objectives: Hydrocephalus (HC) is caused by accumulating cerebrospinal fluid resulting in enlarged ventricles and neurological symptoms. HC can be treated via a shunt in a subset of patients; identifying which individuals will respond through noninvasive imaging would avoid complications from unsuccessful treatments. This preliminary work is a longitudinal study applying MR Elastography (MRE) to HC patients with a focus on normal pressure hydrocephalus (NPH). Read More

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http://dx.doi.org/10.1016/j.acra.2020.03.009DOI Listing

Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus.

PLoS One 2020 24;15(4):e0232275. Epub 2020 Apr 24.

Department of Neuroscience, Neurology, Uppsala University Hospital, Uppsala, Sweden.

Background And Purpose: The idiopathic normal pressure hydrocephalus (iNPH) Radscale was developed to standardize the evaluation of radiological signs in iNPH. The purpose of this study was to estimate the diagnostic accuracy of the iNPH Radscale in a sample of "true positive" and "true negative" cases.

Methods: Seventy-five patients with definite iNPH, i. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232275PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182203PMC

The Use of Rapid Sequence Magnetic Resonance Imaging of the Brain as a Screening Tool for the Detection of Gross Intracranial Pathology in Children Presenting to the Emergency Department With a Chief Complaint of Persistent or Recurrent Headaches.

Pediatr Emerg Care 2020 Apr 16. Epub 2020 Apr 16.

From the Pediatric Emergency/Trauma Center Saint Joseph Children's Hospital and Medical Center; and Vascular and Interventional Radiology Florida Hospital Carollwood, Tampa, FL.

Objective: The purpose of the study, was to assess the utility of rapid sequence brain magnetic resonance imaging (RS-MRI), as a screening tool to detect gross intracranial pathology in children that present to the emergency department, with a chief complaint of persistent or recurrent headaches. Rapid sequence MRI of the brain is a radiation-free technique that is used to evaluate ventricular size in children with shunted hydrocephalus, who present to the emergency department with symptomatology consistent with shunt malfunction.

Methods: The study evaluated RS-MRI radiographic findings of 105 children that presented to a busy tertiary care pediatric emergency/trauma center between May 1, 2013, and May 31, 2015. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002089DOI Listing

Intracranial pressure elevation alters CSF clearance pathways.

Fluids Barriers CNS 2020 Apr 16;17(1):29. Epub 2020 Apr 16.

Department of Radiation Sciences, Umeå University, Umeå, Sweden.

Background: Infusion testing is a common procedure to determine whether shunting will be beneficial in patients with normal pressure hydrocephalus. The method has a well-developed theoretical foundation and corresponding mathematical models that describe the CSF circulation from the choroid plexus to the arachnoid granulations. Here, we investigate to what extent the proposed glymphatic or paravascular pathway (or similar pathways) modifies the results of the traditional mathematical models. Read More

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http://dx.doi.org/10.1186/s12987-020-00189-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161287PMC

Standardized regression-based clinical change score cutoffs for normal pressure hydrocephalus.

BMC Neurol 2020 Apr 16;20(1):140. Epub 2020 Apr 16.

Department of Neurology, Johns Hopkins University School of Medicine, 5200 Eastern Ave CTR STE 5100, Baltimore, MD, 21224, USA.

Background: Presently, for patients presenting with suspected Normal Pressure Hydrocephalus (NPH) who undergo temporary drainage of cerebrospinal fluid (CSF) there is no defined model to differentiate chance improvement form clinical significance change at the individual patient level. To address this lack of information we computed standard regression based clinical change models for the 10 Meter Walk Test, Timed Up & Go, Dual Timed Up & Go, 6-Minute Walk Test, Mini-Balance Evaluation Systems Test, Montreal Cognitive Assessment, and Symbol Digit Modalities using data from patients with suspected NPH that underwent temporary drainage of CSF. These clinically significant change modes can classify clinically significant improvement following temporary drainage of CSF at the individual patient level. Read More

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http://dx.doi.org/10.1186/s12883-020-01719-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164303PMC

Dopaminergic Degeneration and Small Vessel Disease in Patients with Normal Pressure Hydrocephalus Who Underwent Shunt Surgery.

J Clin Med 2020 Apr 11;9(4). Epub 2020 Apr 11.

Department of Neurosurgery, Hualien Tzu Chi Hospital/ Tzu Chi University, Hualien 970, Taiwan.

The diagnosis of idiopathic normal pressure hydrocephalus (iNPH) and the outcome of lumboperitoneal shunt treatment remains to be systematically explored. Here, we aim to evaluate whether the severity of dopaminergic degeneration and white matter small vessel disease could be predictors of outcome for iNPH patients subjected to lumboperitoneal shunt treatment. This is a single center retrospective study with 39 patients with probable iNPH undergoing programmable surgical lumboperitoneal shunt from June 2016 to March 2018 at Hualien Tzu Chi Hospital. Read More

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http://dx.doi.org/10.3390/jcm9041084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230300PMC

Lost Marbles Cannot Be Found: Delayed Diagnosis of Normal Pressure Hydrocephalus.

Am J Med 2020 Apr 11. Epub 2020 Apr 11.

Wexham Park Hospital, Frimley Health NHS Foundation Trust, UK; University of Cyprus Medical School, Nicosia. Electronic address:

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http://dx.doi.org/10.1016/j.amjmed.2020.02.057DOI Listing

Indication of Thalamo-Cortical Circuit Dysfunction in Idiopathic Normal Pressure Hydrocephalus: A Tensor Imaging Study.

Sci Rep 2020 Apr 9;10(1):6148. Epub 2020 Apr 9.

Department of Neurology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Idiopathic normal pressure hydrocephalus (iNPH) is a disorder with unclear pathophysiology. The diagnosis of iNPH is challenging due to its radiological similarity with other neurodegenerative diseases and ischemic subcortical white matter changes. By using Diffusion Tensor Imaging (DTI) we explored differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in iNPH patients (before and after a shunt surgery) and healthy individuals (HI) and we correlated the clinical results with DTI parameters. Read More

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http://dx.doi.org/10.1038/s41598-020-63238-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145806PMC
April 2020
5.078 Impact Factor

Shunt Treatment for Coccidioidomycosis-Related Hydrocephalus: A Single-Center Series.

World Neurosurg 2020 Apr 2. Epub 2020 Apr 2.

Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.

Objective: Coccidioidomycosis is a fungal infection endemic to the southwestern United States. Hydrocephalus can develop after intracranial dissemination, and management of this disease entity is difficult. We present our institutional experience with shunting coccidioidomycosis-related hydrocephalus. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.03.135DOI Listing

Cerebrospinal fluid dynamics in idiopathic normal pressure hydrocephalus on four-dimensional flow imaging.

Eur Radiol 2020 Apr 3. Epub 2020 Apr 3.

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

Objectives: To evaluate complex CSF movements and shear stress in patients with idiopathic normal pressure hydrocephalus (iNPH) on four-dimensional (4D) flow MRI.

Methods: Three-dimensional velocities and volumes of the reciprocating CSF movements through 12 ROIs from the foramen of Monro to the upper cervical spine were measured in 41 patients with iNPH, 23 patients with co-occurrence of iNPH and Alzheimer's disease (AD), and 9 age-matched controls, using 4D flow imaging and application. Stroke volume, reversed-flow rate, and shear stress were automatically calculated. Read More

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http://dx.doi.org/10.1007/s00330-020-06825-6DOI Listing

Peripheral Facial Nerve Palsy After Ventriculoperitoneal Shunt Surgery: An Anatomical Perspective.

Turk Neurosurg 2019 Nov 25. Epub 2019 Nov 25.

Istanbul Training and Research Hospital, Neurosurgery Clinic, Istanbul, Turkey.

In this report, we present a case of peripheral facial nerve palsy (FNP) due to injury of the facial nerve trunk that occurred during tunneling of a VP shunt catheter. We aimed to present the preventive measures by taking the anatomical causes of this complication. An 75-year old was stated a VP shunt surgery for treatment of Normal Pressure Hydrocephalus (NPH). Read More

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http://dx.doi.org/10.5137/1019-5149.JTN.27063-19.4DOI Listing
November 2019

Silver-impregnated, antibiotic-impregnated or non-impregnated ventriculoperitoneal shunts to prevent shunt infection: the BASICS three-arm RCT.

Health Technol Assess 2020 Mar;24(17):1-114

Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK.

Background: Insertion of a ventriculoperitoneal shunt to treat hydrocephalus is one of the most common neurosurgical procedures worldwide. Shunt infection affects up to 15% of patients, resulting in long hospital stays, multiple surgeries and reduced cognition and quality of life.

Objectives: The aim of this trial was to determine whether or not antibiotic-impregnated ventriculoperitoneal shunts (hereafter referred to as antibiotic shunts) (e. Read More

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http://dx.doi.org/10.3310/hta24170DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7184313PMC

Cerebrospinal fluid dynamics in non-acute post-traumatic ventriculomegaly.

Fluids Barriers CNS 2020 Mar 30;17(1):24. Epub 2020 Mar 30.

Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge and Cambridge University Hospital NHS Foundation Trust, Cambridge, UK.

Background: Post-traumatic hydrocephalus (PTH) is potentially under-diagnosed and under-treated, generating the need for a more efficient diagnostic tool. We aim to report CSF dynamics of patients with post-traumatic ventriculomegaly.

Materials And Methods: We retrospectively analysed post-traumatic brain injury (TBI) patients with ventriculomegaly who had undergone a CSF infusion test. Read More

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http://dx.doi.org/10.1186/s12987-020-00184-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7106631PMC

Aqueductal Compression by Dilated Virchow-Robin Spaces in the Mesencephalic-Pontine Region Presenting with Symptoms Mimicking Normal Pressure Hydrocephalus: A Case Report and Review of Literature.

World Neurosurg 2020 Mar 19;138:390-397. Epub 2020 Mar 19.

Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore; Department of Neurosurgery, Duke-NUS Medical School, Singapore, Singapore. Electronic address:

Background: Dilatation of Virchow-Robin spaces (dVRS) have been described in the development of hydrocephalic syndromes. We report an unusual case of a type III dVRS presenting as a mimic of normal pressure hydrocephalus (NPH), due to distortion at the level of the cerebral aqueduct.

Case Description: A 59-year-old woman presented with mild traumatic brain injury and possible NPH, due to a history of progressive gait disturbance, recurrent falls, and cognitive decline over a year, in the context of ventriculomegaly. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.03.047DOI Listing

Reliability and Interobserver Variability of Evans' Index and Disproportionately Enlarged Subarachnoid Space Hydrocephalus as Diagnostic Criteria for Idiopathic Normal Pressure Hydrocephalus.

Asian J Neurosurg 2020 Jan-Mar;15(1):107-112. Epub 2020 Feb 25.

Department of Mechanical and Biofunctional Systems, Institute of Industrial Science, The University of Tokyo, Tsukuba, Japan.

Background: The image diagnosis of idiopathic normal-pressure hydrocephalus (iNPH) is based on the ventriculomegaly, whose criterion is an Evans' Index (EI) >0.3. Recently, disproportionately enlarged subarachnoid space hydrocephalus (DESH) has been proposed as a morphological characteristic to iNPH. Read More

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http://dx.doi.org/10.4103/ajns.AJNS_354_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057886PMC
February 2020

Evaluation of the Evan's and Bicaudate Index for Rural Population in Central India using Computed Tomography.

Asian J Neurosurg 2020 Jan-Mar;15(1):94-97. Epub 2020 Feb 25.

Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.

Introduction: Evans index (EI) and Bicaudate index (BCI) are practical markers of ventricular volume and are helpful radiological markers in the diagnosis of normal pressure hydrocephalus. Worldwide, variation exists in normative studies for both these indices. Most of the studies conducted for EI and BCI are based on the Western population data. Read More

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http://dx.doi.org/10.4103/ajns.AJNS_223_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057876PMC
February 2020

The Impact of Comorbid Alzheimer's Disease in a Patient with Normal Pressure Hydrocephalus?

Authors:
Halil Onder

Dement Neurocogn Disord 2020 Mar 28;19(1):31-32. Epub 2020 Feb 28.

Neurology Clinic, Yozgat City Hospital, Yozgat, Turkey.

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http://dx.doi.org/10.12779/dnd.2020.19.1.31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105716PMC

A case of primary central nervous system lymphoma presenting as a shunt complication.

Br J Neurosurg 2020 Mar 12:1-4. Epub 2020 Mar 12.

Department of Neurological Surgery, University of Miami Miller School of Medicine, Lois Pope Life Center, Miami, FL, USA.

The authors describe an 82-year-old female with a right frontal ventriculoperitoneal (VP) shunt for long-standing normal pressure hydrocephalus (NPH) who presented with worsening incontinence and gait instability. She was found to have right lateral ventricle collapse around the shunt catheter and subsequently underwent shunt revision, which failed to improve her symptoms. Magnetic resonance imaging (MRI) was obtained on postoperative day two, which demonstrated a ventricular lesion. Read More

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http://dx.doi.org/10.1080/02688697.2020.1735300DOI Listing

Development of normal pressure hydrocephalus following post-traumatic external hydrocephalus in an adult patient.

Br J Neurosurg 2020 Mar 12:1-4. Epub 2020 Mar 12.

Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

We report the case of 74-year-old patient suspected of post-traumatic external hydrocephalus (EH) following a mild traumatic brain injury with a progressive neurological decline and a concomitant enlargement of subarachnoid spaces without ventriculomegaly on CT scan. A lumbar puncture revealed raised ICP and a careful CSF withdrawal was performed, resulting in an immediate neurological improvement, confirming the diagnosis of EH. During the 20-month follow-up, the patient presented progressive signs of normal pressure hydrocephalus (NPH): gait and cognitive decline, ventriculomegaly and the lumbar infusion study confirmed disturbed CSF dynamics. Read More

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http://dx.doi.org/10.1080/02688697.2020.1738340DOI Listing

Idiopathic Normal Pressure Hydrocephalus (Hakim-Adams Syndrome): Clinical Symptoms, Diagnosis and Treatment.

Psychiatr Danub 2019 Dec;31(Suppl 5):737-744

S.M. Kirov Military Medical Academy, Saint Petersburg, Russia.

Idiopathic normal pressure hydrocephalus is a chronic steadily progressing disease. Nowadays a vital and acute socially significant problem still has not been solved. The etiology and pathogenesis of this disease remain so far poorly understood. Read More

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December 2019

The efficacy and limitation of lumboperitoneal shunt in normal pressure hydrocephalus.

Clin Neurol Neurosurg 2020 Jun 24;193:105748. Epub 2020 Feb 24.

School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; Department of Pediatrics and Genetics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan. Electronic address:

Objective: To investigate whether the efficacy of the lumbar-peritoneal (LP) shunt is sustainable, we measured the outcomes of patients with idiopathic NPH (iNPH) preoperatively and postoperatively.

Patients And Methods: We retrospective reviewed records of 58 patients with iNPH from 2013 to 2015. Exclusion of 7 patients expired, 1 patient shunt infection, and 8 patients was loss of follow-up. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105748DOI Listing

Normal Pressure Hydrocephalus with Primary Presentation of Psychiatric Disturbance?

Authors:
Halil Onder

J Neurol Surg A Cent Eur Neurosurg 2020 Mar 6. Epub 2020 Mar 6.

Neurology Clinic, Yozgat City Hospital, Yozgat, Turkey.

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http://dx.doi.org/10.1055/s-0039-3402772DOI Listing

Calcifying Pseudoneoplasm of Neuraxis (CAPNON) in the Posterior Third Ventricle-Challenge for Neuroendoscopy.

World Neurosurg 2020 Mar 2;138:481-484. Epub 2020 Mar 2.

Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.

Background: We report the first case of a purely intraventricular calcifying pseudoneoplasm of neuraxis (CAPNON) in the posterior third ventricle.

Case Description: A 63-year-old male without any previous medical history presented with Hakim triad. Imaging showed a calcified lesion of the posterior third ventricle with hydrocephalus. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.02.126DOI Listing

Secondary deterioration in patients with normal pressure hydrocephalus after ventriculoperitoneal shunt placement: a proposed algorithm of treatment.

Fluids Barriers CNS 2020 Mar 4;17(1):18. Epub 2020 Mar 4.

Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Straße 7, 12683, Berlin, Germany.

Background: After ventriculoperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (iNPH) with adjustable gravitational valves, a certain proportion of patients develop secondary clinical worsening after initial improvement of clinical symptoms. The aim of this study was to analyze this group of patients with secondary deterioration and to evaluate the performed shunt management.

Methods: For this investigation, we retrospectively reviewed our NPH registry for patients included between 1999 and 2013 with a decrease by a minimum of two points in the Kiefer score in the first year of follow up and an increase of two points in the Kiefer score between the second and the fifth year after shunt surgery (secondary deterioration). Read More

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http://dx.doi.org/10.1186/s12987-020-00180-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7055114PMC

Soluble vascular endothelial-cadherin in CSF after subarachnoid hemorrhage.

Neurology 2020 Mar 27;94(12):e1281-e1293. Epub 2020 Feb 27.

From Neuroprotection Research Laboratories (H.T., S.H.-Y.C., G.H., R.O., M.R.I., J.M., E.R.-B., K.H., C.X., M.M.N., X.W., K.A., E.H.L., J.L.), Departments of Radiology and Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown; Departments of Neurology (S.H.-Y.C., J.W.L.) and Radiology (L.H.), Brigham and Women's Hospital, Boston; Department of Pediatrics, Pediatric Critical Care Medicine (J.L.), Department of Radiology (E.H.L.), and Department of Neurology (M.M.N., E.H.L.), Massachusetts General Hospital, Boston; Department of Neurosurgery (H.T.), Yokohama City University, Yokohama, Japan; and Departments of Critical Care Medicine, Neurology, and Neurosurgery (S.H.-Y.C.), University of Pittsburgh, PA.

Objective: To determine if CSF and plasma levels of soluble vascular endothelial (sVE)-cadherin are associated with functional outcome after subarachnoid hemorrhage (SAH) and to investigate sVE-cadherin effects on microglia.

Methods: Serial CSF and plasma were collected from prospectively enrolled patients with nontraumatic SAH from a ruptured aneurysm in the anterior circulation and who required an external ventricular drain for clinical indications. Patients with normal-pressure hydrocephalus without SAH served as controls. Read More

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http://dx.doi.org/10.1212/WNL.0000000000008868DOI Listing

Neural circuits of idiopathic Normal Pressure Hydrocephalus: A perspective review of brain connectivity and symptoms meta-analysis.

Neurosci Biobehav Rev 2020 May 20;112:452-471. Epub 2020 Feb 20.

Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA. Electronic address:

Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent reversible neurological disorder characterized by impaired locomotion, cognition and urinary control with ventriculomegaly. Symptoms can be relieved with cerebrospinal fluid drainage, which makes iNPH the leading cause of reversible dementia. Because of a limited understanding of pathophysiological mechanisms, unspecific symptoms and the high prevalence of comorbidity (i. Read More

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http://dx.doi.org/10.1016/j.neubiorev.2020.02.023DOI Listing

Corticospinal excitability in idiopathic normal pressure hydrocephalus: a transcranial magnetic stimulation study.

Fluids Barriers CNS 2020 Feb 17;17(1). Epub 2020 Feb 17.

Neurocenter, Neurosurgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a neurodegenerative disease with an unknown etiology. Disturbed corticospinal inhibition of the motor cortex has been reported in iNPH and can be evaluated in a noninvasive and painless manner using navigated transcranial magnetic stimulation (nTMS). This is the first study to characterize the immediate impact of cerebrospinal fluid (CSF) drainage on corticospinal excitability. Read More

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http://dx.doi.org/10.1186/s12987-020-0167-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025402PMC
February 2020