| 1. |
- Blomsterwall, Elisabeth, et al.
(författare)
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Postural disturbance in patients with normal pressure hydrocephalus.
- 2000
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314. ; 102:5, s. 284-91
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Tidskriftsartikel (refereegranskat)abstract
- The postural function in 52 patients with normal pressure hydrocephalus (NPH) and in 19 patients with subcortical arteriosclerotic encephalopathy (SAE) was analysed bedside and in 17 of the NPH, 10 of the SAE and 23 healthy individuals (HI) also examined with a force platform. At the bedside examination, no differences in postural functions between NPH and SAE patients were found. The NPH patients improved more in the postural than in motor functions after shunt surgery. The NPH patients had a larger sway area and a higher backward directed velocity of centre of pressure than HI. The direction of the inclination in the sagittal plane was neutral or forward in the NPH and the SAE patients while it was backward in HI. The postural function was better in positions with open eyes in all 3 groups, but significantly less in the NPH patients, indicating a misinterpretation of afferent visual stimuli in the brainstem postural centre.
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| 2. |
- Blomsterwall, Elisabeth, et al.
(författare)
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Postural function and subjective eye level in patients with idiopathic normal pressure hydrocephalus.
- 2011
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Ingår i: Journal of neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 258:7, s. 1341-6
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Tidskriftsartikel (refereegranskat)abstract
- Disturbance of posture is a frequent indication of idiopathic normal pressure hydrocephalus (iNPH) and is characterised by an increased sway in the frontal and sagittal planes. Further, iNPH patients with increased backward sway are known to have a defective perception of the subjective visual vertical (SVV), with the upper portion of an articulated rod tilted towards themselves. The objective of the present study was to compare subjective eye level (SEL) with actual eye level (EL) and compare this data with SVV and postural function. Twenty iNPH patients and ten normal controls estimated SEL by placing an adjustable horizontal line at EL. Sway pattern and SVV were also examined as previously described. The patients presented larger errors on downward as compared to upward line adjustments; all patients also presented a SVV tilted towards them. The patients swayed more in the sagittal than in the frontal plane at a higher speed than the normal controls, and they were relatively less helped by their vision. This is in accordance with the tendency to fall backwards seen in many iNPH patients. iNPH patients have a tendency to place SEL higher than EL and this, together with examination of SVV and sway pattern, suggests defective internal processing of gravicentric information.
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| 3. |
- Hellström, Per, et al.
(författare)
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Neuropsychological effects of shunt treatment in idiopathic normal pressure hydrocephalus.
- 2008
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Ingår i: Neurosurgery. - 1524-4040. ; 63:3
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To prospectively evaluate the effects of shunting on the neuropsychological performance of patients with idiopathic normal pressure hydrocephalus (INPH), to compare their performance with that of healthy individuals, and to estimate the predictive utility of putatively important factors. METHODS: A consecutive series of 47 patients with INPH underwent neurological, radiological, and neuropsychological examinations before and 3 months after shunt surgery. The same neuropsychological tests, measuring simple and target reaction times, dexterity, memory and learning, working memory, and aspects of executive functioning, were also administered to 159 healthy individuals. RESULTS: Performance on all neuropsychological tests, except Simple Reaction Time and Digit Span, significantly improved after surgery, with more severe functional deficits showing greatest improvement. Age, education, duration, vascular comorbidity, sex, and onset symptom all failed to predict the neuropsychological effects of treatment. Despite improvement 3 months after shunt surgery, INPH patients were still outperformed by healthy individuals. CONCLUSION: Most of the wide range of neuropsychological functions that are affected by INPH are markedly improved by shunt treatment, but not completely restored.
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| 4. |
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| 5. |
- Tisell, Magnus, 1964, et al.
(författare)
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Neurological symptoms and signs in adult aqueductal stenosis.
- 2003
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314. ; 107:5, s. 311-7
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Tidskriftsartikel (refereegranskat)abstract
- To comprehensively describe and compare prospectively (pre/postoperatively) the symptomatology in aqueductal stenosis (AS) vs idiopathic normal pressure hydrocephalus (INPH).Twenty-seven patients with AS and 39 patients with INPH were consecutively included. Postural functions, gait, wakefulness, cognitive functions, urinary continence and headache were examined before and 3 months after treatment with shunt operation or endoscopic ventriculostomy.The AS patients had better postural functions, walked faster, performed better cognitively and had a higher wakefulness than INPH patients, but these differences were explained by age differences between groups. The frequency of incontinence was similar in the two patients groups. Headache occurred more frequently in AS, but independently of the other symptoms. Most symptoms and signs improved after surgery.Patients with AS had a higher frequency of headaches than INPH patients, but otherwise the symptomology of the two groups was not found to differ after correcting for age differences.
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| 6. |
- Wikkelsö, Carsten, et al.
(författare)
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Subjective visual vertical and Romberg's test correlations in hydrocephalus.
- 2003
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Ingår i: Journal of neurology. - : Springer Science and Business Media LLC. - 0340-5354 .- 1432-1459. ; 250:6, s. 741-5
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Tidskriftsartikel (refereegranskat)abstract
- Exploration of the subjective visual vertical in pitch and Romberg's test in patients with hydrocephalus. Patients Eleven patients with communicating normal pressure hydrocephalus and six with non-communicating hydrocephalus due to aqueductal stenosis were examined before and after surgical treatment.The subjective visual vertical was examined with a simple, custom-made articulated rod. The rod was faintly illuminated from within so as to appear floating in space when presented in darkness. The test task was to manually adjust the rod's position in pitch so that it appeared perfectly vertical. Romberg's test was performed under standardized conditions.Patients with a backward movement on Romberg's test showed a deviation of the subjective visual vertical, tilting the upper end of the rod closer to their eyes. Patients moving in other directions tilted the rod in the opposite direction (p < 0.01). The time in which the patients managed Romberg's test with open eyes correlated with the intratest variability of rod placement (r = 0.86, p < 0.001). After surgery, improvements on Romberg's test correlated with a decreased intratest variability of the subjective visual vertical. There were no differences between the two patient groups.Quantitative measurements of the subjective visual vertical in pitch correlate strongly with results of Romberg's test in patients with hydrocephalus.
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