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High Risk of Dement...
High Risk of Dementia in Ventricular Enlargement with Normal Pressure Hydrocephalus Related Symptoms
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- Koivisto, Anne M. (author)
- Univ Eastern Finland, Inst Clin Med, Neurol Unit, Kuopio, Finland.;Kuopio Univ Hosp, Neurol NeuroCtr, SF-70210 Kuopio, Finland.
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- Kurki, Mitja I. (author)
- Kuopio Univ Hosp, Neurosurg NeuroCtr, SF-70210 Kuopio, Finland.
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- Alafuzoff, Irina (author)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi
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- Sutela, Anna (author)
- Kuopio Univ Hosp, Dept Radiol, SF-70210 Kuopio, Finland.
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- Rurnmukainen, Jaana (author)
- Kuopio Univ Hosp, Dept Pathol, SF-70210 Kuopio, Finland.
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- Savolainen, Sakari (author)
- Kuopio Univ Hosp, Neurosurg NeuroCtr, SF-70210 Kuopio, Finland.
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- Vanninen, Ritva (author)
- Kuopio Univ Hosp, Dept Radiol, SF-70210 Kuopio, Finland.;Univ Eastern Finland, Inst Clin Med, Unit Clin Radiol, Kuopio, Finland.
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- Jaaskelainen, Juha E. (author)
- Kuopio Univ Hosp, Neurosurg NeuroCtr, SF-70210 Kuopio, Finland.;Univ Eastern Finland, Inst Clin Med, Unit Neurosurg, Kuopio, Finland.
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- Soininen, Hilkka (author)
- Univ Eastern Finland, Inst Clin Med, Neurol Unit, Kuopio, Finland.;Kuopio Univ Hosp, Neurol NeuroCtr, SF-70210 Kuopio, Finland.
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- Leinonen, Ville (author)
- Kuopio Univ Hosp, Neurosurg NeuroCtr, SF-70210 Kuopio, Finland.;Univ Eastern Finland, Inst Clin Med, Unit Neurosurg, Kuopio, Finland.
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Univ Eastern Finland, Inst Clin Med, Neurol Unit, Kuopio, Finland;Kuopio Univ Hosp, Neurol NeuroCtr, SF-70210 Kuopio, Finland. Kuopio Univ Hosp, Neurosurg NeuroCtr, SF-70210 Kuopio, Finland. (creator_code:org_t)
- 2016
- 2016
- English.
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In: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 52:2, s. 497-507
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
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- Background: Differential diagnosis of ventricular enlargement with normal pressure hydrocephalus (NPH) related symptoms is challenging. Patients with enlarged ventricles often manifest cognitive deterioration but their long-term outcome is not well known. Objectives: We aim to evaluate long-term cognitive outcome in patients with enlarged ventricles and clinically suspected NPH. Methods: A neurologist and a neurosurgeon clinically evaluated 468 patients with enlarged ventricles and suspected NPH using radiological methods, intraventricular pressure monitoring, and frontal cortical brain biopsy. The neurologist confirmed final diagnoses after a median follow-up interval of 4.8 years. Results: Altogether, 232 patients (50%) with enlarged ventricles did not fulfill the criteria for shunt surgery. The incidence of dementia among patients with enlarged ventricles, and at least one NPH-related symptom with adequate follow-up data (n = 446) was high, varying from 77 (iNPH, shunt responders) to 141/1000 person-years (non-shunted patients with enlarged ventricles). At the end of the follow-up, 59% of all these patients were demented. The demented population comprised 73% of non-shunted patients with enlarged ventricles, 63% of shunted iNPH patients that did not respond to treatment, and 46% of iNPH patients that were initially responsive to shunting. The most common cause of dementia was Alzheimer's disease (n = 94, 36%), followed by vascular dementia (n= 68, 26%). Conclusions: One-half of patients with enlarged ventricles and clinically suspected NPH were not shunted after intraventricular pressure monitoring. Dementia caused by various neurodegenerative diseases was frequently seen in patients with ventricular enlargement. Thus, careful diagnostic evaluation in collaboration with neurologists and neurosurgeons is emphasized.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Alzheimer's disease
- cognition
- dementia
- memory
- normal pressure hydrocephalus
- prognosis
- vascular dementia
- ventricular enlargement
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Koivisto, Anne M ...
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Kurki, Mitja I.
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Alafuzoff, Irina
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Sutela, Anna
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Rurnmukainen, Ja ...
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Savolainen, Saka ...
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show more...
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Vanninen, Ritva
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Jaaskelainen, Ju ...
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Soininen, Hilkka
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Leinonen, Ville
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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Journal of Alzhe ...
- By the university
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Uppsala University