gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Normal pressure hydrocephalus – are there predictive values for the response rate for shunting?

Normaldruckhydrozephalus – gibt es Prediktoren für den Therapieerfolg mit einer Liquorableitung

Meeting Abstract

  • corresponding author S.-U. Pauli - Klinik für Neurochirurgie, Otto-von-Guericke-Universität Magdeburg
  • I. Eisfeld - Klinik für Neurologie, Otto-von-Guericke Universität Magdeburg
  • B. Heimann - Klinik für Neurologie, Otto-von-Guericke-Universität Magdeburg
  • I. Bondar - Klinik für Neurochirurgie, Otto-von-Guericke-Universität Magdeburg
  • R. Firsching - Klinik für Neurochirurgie, Otto-von-Guericke-Universität Magdeburg

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP145

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0413.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Pauli et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Normal pressure hydrocephalus (NPH) is one of the few dementias which can be treated with success. A variety of methods have been proposed to confirm the diagnosis of NPH and to determine which patients are likely to respond to shunting of cerebrospinal fluid (CSF). The aim of the present study was to compare the withdrawal of CSF by lumbar puncture, continuous intracranial pressure (ICP) monitoring and neuropsychological improvement following withdrawal of 30 ml CSF in patients with suspected NPH.

Methods

From March 2003 until now, 30 consecutive patients with radiographic and clinical signs suggesting the presence of NPH were included in the ongoing study. In 27 Patient a CSF withdrawal via lumbar puncture (LP) was performed. A continuous invasive ICP monitoring was done in 18 patients for at least forty-eight hours. The ICP signal was digitized by means of an analog-to-digital converter (50 Hz sampling rate) and stored on a personal computer for off-line evaluation. In addition, a neuropsychological test battery including assessment of orientation, memory, alertness and executive function was performed two days prior to and two days following the withdrawal of 30 ml of CSF.

Results

5 out of 18 patients showed an elevated opening pressure and persistently elevated ICP above 150 mm H2O or recurrent pressure waves above 200 mm H2O. A neuropsychological improvement was observed in 3 of these 5 patients following CSF withdrawal. 8 out of 27 showed a general clinical improvement after LP and 5 of them a neuropsychological improvement as well. A shunt procedure was performed in 4 patients with elevated ICP and 7 patient improved after LP including the 5 patients with improved neuropsychological status. One of each group refused shunting.

Conclusions

Our preliminary results suggest that neuropsychological assessment prior to and after CSF withdrawal constitutes a valuable diagnostic approach in addition to continuous ICP monitoring or CSF withdrawal with lumbar puncture in patients with suspected NPH.