Normal pressure hydrocephalus. Results of shunting correlated with diagnostic tests in 55 patients

Abstract

Object: The purpose of this study was to evaluate the efficacy of ventricular shunting in normal pressure hydrocephalus (NPH). Methods: The authors retrospectively studied outcomes in NPH patients in whom shunts were implanted. At follow-up examinations up to one year, clinical symptoms were recorded according to a new NPH outcome rating scale, the modified Rankin score and the Mini-Mental State Examination. Comorbidities and complications during this period were also analyzed. Results: A total of 55 patients with NPH were included, with a male predominance (69% of men), an average age of 70 years. Comorbidities are multiple, hypertension is the most common factor in 55% of cases. 76% of patients are classified as having idiopathic NPH. The CSF tap test allows the evacuation of at least 40 ml of CSF and RCSF measurements in 55 patients. All these patients received a shunt withe programmable valve. An improvement in gait was observed in 88% of patients, 91% in balance and 84% in continence. The improvement in the field of neuropsychology is 34% after one year of shunt. 87% of patients were improved according to mRS. 27% of patients had complications and were treated conservatively or surgically. Conclusions: Ventricular shunt implantation is a safe procedure and can improve symptoms in 98% of patients with NPH in the medium term. Keywords: Cerebrospinal fluid (CSF) tap test; Normal pressure hydrocephalus (NPH); NPH assessment scores; Programmable valve; Symptomatic triade of Hakim