One-year outcome in the European multicentre study on iNPH

• Objectives To assess the 1-year outcome after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods Patients (n = 142) were prospectively included in the European multicentre study by 13 centres. Diagnoses were based solely on clinical and radiological findings. All received a programmable ventriculoperitoneal shunt. Re-examinations, 12 months after surgery, were performed in 115 patients, and the outcome was assessed by the modified Rankin scale (mRs) and a new iNPH grading scale. Improvement was defined as =1 step on the mRs and =5 points on the iNPH scale. Results The scores on both scales were significantly improved after 1 year of shunt treatment (Ps < 0.001). Sixty-nine per cent of the patients were improved according to the mRs and 84% according to the iNPH scale. The proportion able to live independently (scores 02 on the mRs) was increased from 53% before to 82% 12 months after surgery (P < 0.001). Neither classification (typical or questionable) nor comorbidity affected the level of improvement. Patients not completing the study were worse off with regard to their clinical condition at entry than completers. Twenty-eight per cent of the patients experienced complications and were either conservatively (13%) or surgically (15%) treated. Conclusion The results of this prospective multicentre study on patients with iiNPH diagnosed solely on clinical and radiological criteria support shunt surgery in patients presenting with symptoms and signs and MRI findings suggestive of iNPH.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

Nyckelord

idiopathic normal pressure hydrocephalus

outcome

symptoms and signs

iNPH scale

multicentre

normal-pressure hydrocephalus

cerebrospinal-fluid

outflow resistance

tap-test

population

prevalence

prediction

parameters

management

surgery

ns jtj

1985

clinical neurology and neurosurgery

v87

p159

lstein mf

1975

journal of psychiatric research

v12

p189

KEUCHI T

2000

Neurol Med Chir (Tokyo)

V40

P7

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)