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Comparative Study
, 89 (5), 311-6

Idiopathic Normal Pressure Hydrocephalus: The CSF Tap-Test May Predict the Clinical Response to Shunting

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Comparative Study

Idiopathic Normal Pressure Hydrocephalus: The CSF Tap-Test May Predict the Clinical Response to Shunting

T Sand et al. Acta Neurol Scand.

Abstract

A follow-up study was performed in nine patients with idiopathic normal pressure hydrocephalus (NPH) 37 months (mean) after shunting and 10 non-operated controls with comparable degrees of ventricular enlargement, gait disorder, and dementia. Five operated patients vs. no controls reported sustained general improvement (p < 0.02). Objectively improved gait at follow-up (compared with preoperative status) was found in five of the six tested NPH-patients vs. none of the controls (p < 0.005). Improved gait and/or psychometric function was found in four of six NPH vs. none of eight control patients (p < 0.02) after drainage of 40 ml cerebrospinal fluid (CSF tap-test). Improved gait during the CSF tap-test predicted continued improvement at follow-up. Temporal horn size was the only radiological variable which showed a (moderate) positive correlation with resistance to CSF absorption and rate of pressure increase. The size of the third ventricle diminished in parallel with clinical improvement.

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