Abstract
Normal pressure Hydrocephalus (NPH) is predominantly treated with a ventriculoperitoneal shunt (VPS) resulting in improvement in the Hakim triad (mobility, cognitive function, urinary continence). There are a population of patients who experience an improvement in symptoms post shunt insertion followed by a subsequent deterioration in their condition in the proceeding months / years. At our institution, a large volume (min 40ml) CSF withdrawal is made via the shunt reservoir in these patients, measuring pre/post mobility and cognitive function. Comparison is then made between pre/post results and if a clear improvement is seen, VP shunt surgical revision is offered.
Highlights
Normal pressure Hydrocephalus (NPH) is predominantly treated with a ventriculoperitoneal shunt (VPS) resulting in improvement in the Hakim triad
A large volume CSF withdrawal is made via the shunt reservoir in these patients, measuring pre/post mobility and cognitive function
Walking test assessed over a 10m course at baseline, post initial shunt, pre Tap test, post tap test and post shunt revision were compared
Summary
Normal pressure Hydrocephalus (NPH) is predominantly treated with a ventriculoperitoneal shunt (VPS) resulting in improvement in the Hakim triad (mobility, cognitive function, urinary continence). There are a population of patients who experience an improvement in symptoms post shunt insertion followed by a subsequent deterioration in their condition in the proceeding months / years. A large volume (min 40ml) CSF withdrawal is made via the shunt reservoir in these patients, measuring pre/post mobility and cognitive function. Comparison is made between pre/post results and if a clear improvement is seen, VP shunt surgical revision is offered
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