OBJECTIVE To describe the natural history and shunt outcome in patients with normal pressure hydrocephalus (NPH) and the variables that influence both. METHOD Motor and cognitive parameters of 35 patients with NPH, as well as shunt surgery status, were registered at two time points (T0 and T1). RESULTS Thirteen patients underwent shunt surgery. Favorable outcome in gait function occurred in...

Reduction of ventricular size was determined by repeated computed tomography in 30 adult patients shunted for normal pressure hydrocephalus (NPH) and related to the pressure-volume index (PVI) and resistance to outflow of cerebrospinal fluid (Rcsf) measured before shunting. Rapid and marked reduction of ventricular size (n = 10) was associated with a significantly lower PVI than slow and modera...

OBJECTIVES Gait abnormalities are an early clinical symptom in normal pressure hydrocephalus (NPH), and subjective improvement in gait after temporary removal of CSF is often used to decide to perform shunt surgery. We investigated objective measures to compare gait before and after CSF drainage and shunt surgery. DESIGN Twenty patients and nine controls were studied. Quantitative gait measur...

OBJECTIVE Are hydrostatic valves superior to conventional differential pressure shunts in patients with normal- pressure hydrocephalus, with regard to the postoperative results of treatment and possible complications? METHODS From September 1997 to January 2002, 60 patients with idiopathic normal-pressure hydrocephalus were treated by surgical implantation of a hydrostatic valve (Miethke dual...

OBJECTIVE Previously, we documented association between CSF circulation and transcranial-Doppler derived autoregulation in non-shunted patients suffering from hydrocephalus. In the present study we sought to investigate the relationship between the resistance to CSF outflow and pressure-reactivity both in shunted and non-shunted NPH patients. MATERIAL AND METHODS Sixty-eight patients (47 non-...

OBJECTIVES The aim of the report is to define the indications and results of endoscopic third ventriculostomy (ETV) in idiopathic normal pressure hydrocephalus and to discuss the physiopathological mechanism of this procedure. METHODS The cases of 110 patients with idiopathic normal pressure hydrocephalus who underwent ETV in four Italian neurosurgical centers were retrospectively reviewed. T...

Invasive monitoring of pulsatile intracranial pressure can accurately predict shunt response in patients with idiopathic normal pressure hydrocephalus, but may potentially cause complications such as bleeding and infection. We tested how a proposed surrogate parameter for pulsatile intracranial pressure, the phase-contrast magnetic resonance imaging derived pulse pressure gradient, compared wit...