scholarly journals The First Examination of Diagnostic Performance of Automated Measurement of the Callosal Angle in 1856 Elderly Patients and Volunteers Indicates That 12.4% of Exams Met the Criteria for Possible Normal Pressure Hydrocephalus

2021 ◽  
Author(s):  
M. Borzage ◽  
A. Saunders ◽  
J. Hughes ◽  
J.G. McComb ◽  
S. Blüml ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Normal Pressure Hydrocephalus ◽  
Diagnostic Performance ◽  
Normal Pressure ◽  
Automated Measurement

scholarly journals Diagnostic Performance of Glymphatic System Evaluation Using Diffusion Tensor Imaging in Idiopathic Normal Pressure Hydrocephalus and Mimickers

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Hajime Yokota ◽  
Arvind Vijayasarathi ◽  
Milos Cekic ◽  
Yoko Hirata ◽  
Michael Linetsky ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Normal Pressure Hydrocephalus ◽  
Diagnostic Performance ◽  
Roc Analysis ◽  
Diffusion Tensor ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Glymphatic System ◽  
Evans Index ◽  
Diffusion Tensor Imaging Dti

Purpose. To investigate the pathological change of the glymphatic system in idiopathic normal pressure hydrocephalus (iNPH) using diffusion tensor imaging (DTI) analysis. Materials and Methods. 24 right-handed patients were referred to our hydrocephalus clinic for assessment of ventriculomegaly and gait impairment. 12 of 24 were diagnosed as pseudo-iNPH (piNPH) based on assessment by a neurologist. Diffusivity maps in the direction of the x-axis (right-to-left) (Dx), y-axis (anterior-to-posterior) (Dy), and z-axis (inferior-to-superior) (Dz) were computed. The diffusion map was coregistered to International Consortium for Brain Mapping (ICBM) DTI-81 atlas. The analysis along the perivascular space (ALPS) index was defined as mean (Dxpro, Dypro)/mean (Dypro, Dzasc), where Dxpro and Dxasc are Dx values in the projection and association fiber areas, respectively. Evans index and callosal angle were also assessed on each case. Results. ALPS indexes of the control, piNPH, and iNPH cases were 1.18 ± 0.08, 1.08 ± 0.03, and 0.94 ± 0.06, respectively, and there were significant differences among the groups (control vs. piNPH, P = 0.003; control vs. iNPH P < 0.001; piNPH vs. iNPH, P < 0.001). Area under curve (AUC) was 0.92, 1.00, and 1.00 on control vs. piNPH, control vs. iNPH, and piNPH vs. iNPH on ROC analysis. Between piNPH and NPH, ALPS index has higher diagnostic performance than Evans index and callosal angle (AUC = 1.00 vs. 0.84, P = 0.028; AUC = 1.00 vs. 0.74, P = 0.016). Conclusion. Atlas-based ALPS index using the DTI method differentiated among iNPH, piNPH, and controls clearly.

The applause sign in elderly patients with idiopathic normal pressure hydrocephalus

2020 ◽  
pp. 1-6
Author(s):  
Derya Kaya ◽  
Neziha Erken ◽  
Mehmet Selman Ontan ◽  
Zekiye Sultan Altun ◽  
Ahmet Turan Isik
Keyword(s):  
Elderly Patients ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Applause Sign

EVALUATION AND TREATMENT OF PATIENTS WITH SUSPECTED NORMAL PRESSURE HYDROCEPHALUS ON LONG-TERM WARFARIN ANTICOAGULATION THERAPY

Neurosurgery ◽  
2007 ◽  
Vol 60 (3) ◽  
pp. 497-502 ◽  
Author(s):  
C. Rory Goodwin ◽  
Siddharth Kharkar ◽  
Paul Wang ◽  
Siddharth Pujari ◽  
Daniele Rigamonti ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Normal Pressure Hydrocephalus ◽  
Subdural Hematoma ◽  
Normal Pressure ◽  
Shunt Revision ◽  
Shunt Surgery ◽  
Csf Drainage ◽  
Spinal Catheter

Abstract OBJECTIVE Long-term anticoagulation is often considered a contraindication to shunt surgery for elderly patients with normal pressure hydrocephalus (NPH). However, no studies have investigated this question. METHODS We evaluated 25 patients who were taking warfarin for NPH between 2001 and 2004 with a protocol of cerebrospinal fluid (CSF) pressure monitoring and controlled CSF drainage via spinal catheter. Warfarin was stopped 5 to 7 days before lumbar puncture or shunt surgery and restarted 3 to 5 days after operation or at the time of discharge from the hospital. Programmable shunts with antisiphon devices set at the high-pressure range were preferentially used and adjusted in small increments. RESULTS After CSF drainage, 16 patients showed improvement and 15 underwent shunt surgery. Thirteen (87%) out of these 15 patients showed significant improvement in at least one symptom during a mean follow-up period of 8.2 months (range, 1–70 mo) after shunt surgery. There were two bleeding complications. One patient (6.7%) with cirrhosis who developed a subdural hematoma 13 days after operation had the shunt removed; another patient who developed an abdominal subcutaneous hematoma 5 days after operation required surgical evacuation and shunt revision surgery. Otherwise, 14 (93.3%) out of the 15 patients had no subdural hematoma during the follow-up period and there were no thromboembolic complications while the patients were not taking warfarin. CONCLUSION Elderly patients on long-term warfarin anticoagulation can be safely evaluated and treated for NPH using a protocol of continuous CSF drainage via spinal catheter for diagnosis, cautious periprocedural management of anticoagulation, and use of programmable shunts with antisiphon devices. The risk of subdural hematoma is not higher than reported series. Long-term anticoagulation with warfarin is not a contraindication per se for shunt surgery in NPH.

scholarly journals Hearing Change After Shunt Placement in Elderly Patients with Idiopathic Normal-Pressure Hydrocephalus

2020 ◽  
Vol 123 (8) ◽  
pp. 737-744
Author(s):  
Saiko Sugiura ◽  
Masahiko Bundo ◽  
Hirokazu Suzuki ◽  
Takafumi Nakada ◽  
Yasue Uchida ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Shunt Placement
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