Summary
The objective of this prospective study was to find outcome predictors for better selection for treatment of normal-pressure hydrocephalus (NPH) patients. A total of 125 patients were evaluated and provided with a gravitational shunt.
Cerebrospinal fluid hydrodynamics provided better predictive values if an algorithm to shunt all patients with a pressure/volume index of <30 mL or resistance to outflow > 13 mmHg/mL × min was used. In general, outcome became worse with increasing anamnesis duration, worse preoperative clinical state, and increasing comorbidity. If one of these parameters was lower than a critical value, the shunt-responder rate was about 90% and the normally negative influence of older age was not seen. The well-known paradigm of a worse prognosis with NPH is not the result of the hydrocephalus etiology itself, but the consequence of a typical accumulation of negative outcome predictors as a consequence of the misinterpretation of normal aging and delayed adequate treatment.
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Kiefer, M., Eymann, R., Steudel, W.I. (2006). Outcome predictors for normal-pressure hydrocephalus. In: Hoff, J.T., Keep, R.F., Xi, G., Hua, Y. (eds) Brain Edema XIII. Acta Neurochirurgica Supplementum, vol 96. Springer, Vienna. https://doi.org/10.1007/3-211-30714-1_75
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DOI: https://doi.org/10.1007/3-211-30714-1_75
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