Normal pressure hydrocephalus. Predictive value of the cerebrospinal fluid tap-test

Acta Neurol Scand. 1986 Jun;73(6):566-73. doi: 10.1111/j.1600-0404.1986.tb04601.x.


Twenty-seven patients with normal pressure hydrocephalus were operated upon by a ventriculo-peritoneal shunt. Selection for shunt surgery was based on typical symptoms (gait disturbancy, mental deterioration and urgency incontinence) and characteristic changes at cranial computed tomography and/or radionuclide cisternography. Prior to operation a cerebrospinal fluid tap-test (CSF-TT) was performed with measurements of psychometric functions and gait pattern before and after a lumbar puncture of 50 cc CSF. Nineteen patients improved and 5 were unchanged after shunt operation. Three patients could not be evaluated. Improvement in the psychometric functions and gait pattern after lumbar puncture correlated to improvement after the shunt operation (r = 0.64, p less than 0.01: r = 0.96, p less than 0.001, respectively). Improvement in 2 or more of the 4 tests used (3 psychometric and 1 gait test) at CSF-TT implied in all cases successful result of the shunt operation. It was concluded that CSF-TT could predict which NPH patient will improve by a shunt operation, and albeit to envisage the degree of improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cerebrospinal Fluid Shunts
  • Female
  • Humans
  • Hydrocephalus / cerebrospinal fluid*
  • Hydrocephalus, Normal Pressure / cerebrospinal fluid*
  • Hydrocephalus, Normal Pressure / psychology
  • Hydrocephalus, Normal Pressure / surgery
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Postoperative Period
  • Prognosis
  • Spinal Puncture*