Preoperative spinal hydrodynamics versus clinical change 1 year after shunt treatment in idiopathic normal pressure hydrocephalus patients

Abstract

Nineteen consecutive cases treated for idiopathic normal pressure hydrocephalus (iNPH) with ventriculo-peritoneal shunts were clinically followed prospectively. Change in clinical state one year after shunt surgery was assessed as change on a 15-3 score NPH Grade Scale. Preoperative spinal hydrodynamics were assessed using a constant-rate lumbar infusion test. The pressure recordings were stored as raw data files and analysed retrospectively with regard to the mean cerebrospinal fluid pressure (CSFP), as well as mean CSFP wave amplitudes. Changes in NPH score 1 year after shunt surgery correlated significantly with the levels of single CSFP wave amplitudes, but not with the lumbar resistance to CSF outflow (R_out). Mean CSFP wave amplitude was thus, in this cohort, a better predictor of clinical change one year after shunt treatment than R_out.

Key words:

• Cerebrospinal fluid pressure
• idiopathic normal pressure hydrocephalus
• outcome
• single pressure waves
• ventriculo-peritoneal shunts