The Current Status of Medical Care for Idiopathic Normal-pressure Hydrocephalus in Medical Centers for Dementia in Japan

Abstract

We used a questionnaire to evaluate how patients with idiopathic normal-pressure hydrocephalus (iNPH) are examined in Medical Centers for Dementia (MCDs), which are qualified medical organizations for dementia patients in Japan. Ninety-eight of 205 MCDs responded to our questionnaire. Accordingly, more than 590 patients with iNPH underwent an MCD examination during the period of 1 year. In regards to the Guidelines for Management of iNPH, 40 of the 98 MCDs used neither the first nor second edition of the Guidelines, even though up-to-date information is available in the second edition of the Guidelines. At most MCDs, consultation with iNPH specialists was performed without a cerebrospinal fluid tap test. At more than half of the responding MCDs, doctors felt that the selection of appropriate candidates for shunt surgery differed from those selected by neurosurgeons. Moreover, 73 out of 87 MCDs argued that patients with iNPH should be examined by both dementia specialists and neurosurgeons after shunt surgery. These results suggest that doctors at MCDs should take advantage of up-to-date information and cooperate with iNPH specialists and neurosurgeons.