Albert M Isaacs1,2, Michael A Williams3, Mark G Hamilton4,5. 1. Department of Neuroscience, Washington University School of Medicine, St. Louis, MO, USA. 2. Division of Neurosurgery, Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada. 3. Adult and Transitional Hydrocephalus and CSF Disorders, Departments of Neurology and Neurological Surgery, University of Washington School of Medicine, Seattle, WA, USA. 4. Division of Neurosurgery, Department of Clinical Neuroscience, University of Calgary, Calgary, Alberta, Canada. mghamilton.hydro@gmail.com. 5. Adult Hydrocephalus Program, Department of Clinical Neuroscience, University of Calgary, Foothills Medical Centre - 12th Floor, Neurosurgery, 1403 - 29 Street NW, Calgary, Alberta, T2N 2T9, Canada. mghamilton.hydro@gmail.com.
Abstract
PURPOSE OF REVIEW: Idiopathic normal pressure hydrocephalus (iNPH) is a surgically treatable neurological disorder of the elderly population that is characterized by abnormal ventricular enlargement due to cerebrospinal fluid (CSF) accumulation and gait disturbance, cognitive impairment, or urinary incontinence. The objective of this review is to present the current diagnostic and treatment approaches for iNPH and to discuss some of the postoperative modalities that complement positive surgical outcomes. RECENT FINDINGS: Although historically reported patient outcomes following iNPH surgery were dismal and highly variable, recent advances in terms of better understanding of the iNPH disease process, better standardization of iNPH diagnostic and treatment processes arising from the adoption of clinical guidelines for diagnosis, treatment and in research methodologies, and availability of long-term follow-up data, have helped reduce the variations to a much improved 73 to 96% reported good outcomes. With careful evaluation, good patient selection, and advanced surgical techniques, iNPH can be surgically treated to return patients close to their pre-iNPH functional status. Institution of an interdisciplinary effort to rehabilitate patients following surgery may help augment their recovery.
PURPOSE OF REVIEW: Idiopathic normal pressure hydrocephalus (iNPH) is a surgically treatable neurological disorder of the elderly population that is characterized by abnormal ventricular enlargement due to cerebrospinal fluid (CSF) accumulation and gait disturbance, cognitive impairment, or urinary incontinence. The objective of this review is to present the current diagnostic and treatment approaches for iNPH and to discuss some of the postoperative modalities that complement positive surgical outcomes. RECENT FINDINGS: Although historically reported patient outcomes following iNPH surgery were dismal and highly variable, recent advances in terms of better understanding of the iNPH disease process, better standardization of iNPH diagnostic and treatment processes arising from the adoption of clinical guidelines for diagnosis, treatment and in research methodologies, and availability of long-term follow-up data, have helped reduce the variations to a much improved 73 to 96% reported good outcomes. With careful evaluation, good patient selection, and advanced surgical techniques, iNPH can be surgically treated to return patients close to their pre-iNPH functional status. Institution of an interdisciplinary effort to rehabilitate patients following surgery may help augment their recovery.
Entities:
Keywords:
Cerebrospinal fluid; Dementia; Hydrocephalus; Normal pressure hydrocephalus
Authors: James P McAllister; Michael R Talcott; Albert M Isaacs; Sarah H Zwick; Maria Garcia-Bonilla; Leandro Castaneyra-Ruiz; Alexis L Hartman; Ryan N Dilger; Stephen A Fleming; Rebecca K Golden; Diego M Morales; Carolyn A Harris; David D Limbrick Journal: Fluids Barriers CNS Date: 2021-11-08
Authors: Johanna Rydja; Lena Kollén; Per Hellström; Katarina Owen; Åsa Lundgren Nilsson; Carsten Wikkelsø; Mats Tullberg; Fredrik Lundin Journal: Fluids Barriers CNS Date: 2021-11-22