Skip to main content
SpringerLink
Log in
Book cover

Movement Disorders in Dementias pp 231–252Cite as

Normal Pressure Hydrocephalus

  • Chapter
  • First Online:

  • 1581 Accesses

Abstract

Although it has been nearly 50 years since its first description of clinical and radiological, there is considerable uncertainty about the diagnosis of normal pressure hydrocephalus because it shares the semiotics with the group of dementias. Hakim’s triad (impaired gait, initially type clumsiness of the lower limbs followed over time by inability to ambulate or maintain an erect posture; cognitive impairment, initially limited to worsening deficits in memory fixation and execution of complex actions; the urinary disorder, initially type “urgent urination” and then complete urinary incontinence) characterizes the progressive course of the adult chronic hydrocephalus. The clinical onset is typically nonspecific, subtle, and most often monosymptomatic. The first diagnostic procedure is a head CT scan and/or brain MRI, which shows an abnormal dilatation of the lateral ventricles and the third ventricle, associated to variable brain atrophy. Not all subjects will develop a set of symptoms, since the altered cerebrospinal fluid dynamics can remain stable for many years or get progressively worse until the appearance of the clinical triad of normal pressure hydrocephalus. The test of intrathecal infusion (Katzman test) carried out at constant speed with the introduction of saline solution into the lumbar subarachnoid space and the concomitant detection of cerebrospinal fluid pressure establishes that patients with outflow resistance ranging from 12 to 19 mmHg/ml/min can improve clinically after surgery. This method requires extensive and prolonged experience of the center of application and the use of computer systems. The withdrawal of lumbar cerebrospinal fluid provides for the evacuation of 30–50 cc of cerebrospinal fluid by lumbar puncture under local anesthesia, preceded and followed by gait assessment and neuropsychological tests. It also uses the continuous withdrawal of CSF with an intrathecal catheter placed for 3 days, in order to drain approximately 135 ml/24 h and the aim of reducing false negatives. After surgery, the patient is usually able to regain a good quality of life, with independence in daily living activities. The duration of such postsurgical improvement is variable, but patients may improve again readjusting the opening pressure of the programmable valve, although a high comorbidity index is strictly related to a poor outcome.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WT. Symptomatic occult hydrocephalus with “normal” cerebrospinal fluid pressure: a treatable syndrome. N Engl J Med. 1965;273:117–26.

    CAS  PubMed  Google Scholar 

  • Aitken RR, Drake CG. Continuous spinal drainage in the treatment of postoperative cerebrospinal-fluid fistulae. J Neurosurg. 1964;21:275–7.

    CAS  PubMed  Google Scholar 

  • Albert F. Lumbar puncture as applied to craniocerebral surgery. Ann Surg. 1918;68:549–50.

    Google Scholar 

  • Alexander GE, DeLong MR, Strick PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci. 1986;9:357–81.

    CAS  PubMed  Google Scholar 

  • Ambarki K, Israelsson H, Wåhlin A, Birgander R, Eklund A, Malm J. Brain ventricular size in healthy elderly: comparison between Evans index and volume measurement. Neurosurgery. 2010;67:94–9.

    PubMed  Google Scholar 

  • Amini A, Schmidt RH. Endoscopic third ventriculostomy in a series of 36 adult patients. Neurosurg Focus. 2005;19:E9.

    PubMed  Google Scholar 

  • Anderson RC, Grant JJ, de la Paz R, Frucht S, Goodman RR. Volumetric measurements in the detection of reduced ventricular volume in patients with normal-pressure hydrocephalus whose clinical condition improved after ventriculoperitoneal shunt placement. J Neurosurg. 2002;97:73–9.

    PubMed  Google Scholar 

  • Aquilina K, Pople IK, Sacree J, Carter MR, Edwards RJ. The constant flow ventricular infusion test: a simple and useful study in the diagnosis of third ventriculostomy failure. J Neurosurg. 2012;116:445–52.

    PubMed  Google Scholar 

  • Aygok G, Marmarou A, Young HF. Three-year outcome of shunted idiopathic NPH patients. Acta Neurochir Suppl. 2005;95:241–5.

    CAS  PubMed  Google Scholar 

  • Bech-Azeddine R, Waldemar G, Knudsen GM, Hogh P, Bruhn P, Wildschiodtz G, Gjerris F, Paulson OB, Juhler M. Idiopathic normal-pressure hydrocephalus: evaluation and findings in a multidisciplinary memory clinic. Eur J Neurol. 2001;8:601–11.

    CAS  PubMed  Google Scholar 

  • Black PM. Idiopathic normal-pressure hydrocephalus. Results of shunting in 62 patients. J Neurosurg. 1980;52:371–7.

    CAS  PubMed  Google Scholar 

  • Bloch O, McDermott MW. Lumboperitoneal shunts for the treatment of normal pressure hydrocephalus. J Clin Neurosci. 2012;19:1107–11.

    PubMed  Google Scholar 

  • Bloom KK, Kraft WA. Paranoia–an unusual presentation of hydrocephalus. Am J Phys Med Rehabil. 1998;77:157–9.

    CAS  PubMed  Google Scholar 

  • Boon AJ, Tans JT, Delwel EJ, Egeler-Peerdeman SM, Hanlo PW, Wurzer HA, Avezaat CJ, de Jong DA, Gooskens RH, Hermans J. Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts. J Neurosurg. 1998;88:490–5.

    CAS  PubMed  Google Scholar 

  • Bouras T, Sgouros S. Complications of endoscopic third ventriculostomy: a systematic review. Acta Neurochir Suppl. 2012;113:149–53.

    PubMed  Google Scholar 

  • Bradley Jr WG, Scalzo D, Queralt J, Nitz WN, Atkinson DJ, Wong P. Normal pressure hydrocephalus: evaluation with cerebrospinal fluid flow measurements at MR imaging. Radiology. 1996;198:523–9.

    PubMed  Google Scholar 

  • Brean A, Eide PK. Prevalence of probable idiopathic normal pressure hydrocephalus in a Norwegian population. Acta Neurol Scand. 2008;118:48–53.

    CAS  PubMed  Google Scholar 

  • Browning W. Lumbar puncture for the removal of cerebro-spinal fluid. In: Browning W, editor. The normal and pathological circulation in the central nervous system. Philadelphia: J. B. Lippincott Company; 1897. p. 54–60.

    Google Scholar 

  • Cabral D, Beach TG, Vedders L, Sue LI, Jacobson S, Myers K, Sabbagh MN. Frequency of Alzheimer’s disease pathology at autopsy in patients with clinical normal pressure hydrocephalus. Alzheimers Dement. 2011;7:509–13.

    PubMed Central  PubMed  Google Scholar 

  • Cage TA, Auguste KI, Wrensch M, Wu YW, Gupta N. Self-reported functional outcome after surgical intervention in patients with idiopathic normal pressure hydrocephalus. J Clin Neurosci. 2011;18:649–54.

    CAS  PubMed  Google Scholar 

  • Casmiro M, Benassi G, Cacciatore FM, D’Alessandro R. Frequency of idiopathic normal pressure hydrocephalus. Arch Neurol. 1989;46:608.

    CAS  PubMed  Google Scholar 

  • Chakravarty A. Unifying concept for Alzheimer’s disease, vascular dementia and normal pressure hydrocephalus – a hypothesis. Med Hypotheses. 2004;63:827–33.

    PubMed  Google Scholar 

  • Chang CC, Kuwana N, Ito S. Management of patients with normal-pressure hydrocephalus by using lumboperitoneal shunt system with the Codman Hakim programmable valve. Neurosurg Focus. 1999;7:e8.

    CAS  PubMed  Google Scholar 

  • Chang S, Agarwal S, Williams MA, Rigamonti D, Hillis AE. Demographic factors influence cognitive recovery after shunt for normal-pressure hydrocephalus. Neurologist. 2006;12:39–42.

    PubMed  Google Scholar 

  • Christensen PB. Normal pressure hydrocephalus in myotonic dystrophy. Eur Neurol. 1988;28:285–7.

    CAS  PubMed  Google Scholar 

  • Clarfield AM. The decreasing prevalence of reversible dementias: an updated meta-analysis. Arch Intern Med. 2003;163:2219–29.

    PubMed  Google Scholar 

  • Colitti MC, Casaccia V, Bella A, Perra A, Binkin N. VETUS a Orvieto un'indagine sulla qualità della vita delle persone con più di 64 anni nel comune di Orvieto. Not Ist Super Sanità. 2006;11:III–IV.

    Google Scholar 

  • Conn HO. Normal pressure hydrocephalus (NPH): more about NPH by a physician who is the patient. Clin Med. 2011;11:162–5.

    PubMed  Google Scholar 

  • Cummings JL, Benson DF. Subcortical dementia. Review of an emerging concept. Arch Neurol. 1984;41:874–9.

    CAS  PubMed  Google Scholar 

  • Cusimano MD, Rewilak D, Stuss DT, Barrera-Martinez JC, Salehi F, Freedman M. Normal-pressure hydrocephalus: is there a genetic predisposition? Can J Neurol Sci. 2011;38:274–81.

    CAS  PubMed  Google Scholar 

  • Czosnyka M, Czosnyka Z, Momjian S, Schmidt E. Calculation of the resistance to CSF outflow. J Neurol Neurosurg Psychiatry. 2003;74:1354.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Damasceno BP, Carelli EF, Honorato DC, Facure JJ. The predictive value of cerebrospinal fluid tap-test in normal pressure hydrocephalus. Arq Neuropsiquiatr. 1997;55:179–85.

    CAS  PubMed  Google Scholar 

  • Dandy WE. Ventriculography following the injection of air into the cerebral ventricles. Ann Surg. 1918;68:5–11.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Delavallée M, Raftopoulos C. Normal pressure hydrocephalus in a patient with myotonic dystrophy: case report with a 10-year follow-up. Neurosurgery. 2006;58:E796.

    PubMed  Google Scholar 

  • Devito EE, Pickard JD, Salmond CH, Iddon JL, Loveday C, Sahakian BJ. The neuropsychology of normal pressure hydrocephalus (NPH). Br J Neurosurg. 2005;19:217–24.

    CAS  PubMed  Google Scholar 

  • Di Lauro L, Mearini M, Bollati A. The predictive value of 5 days CSF diversion for shunting in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry. 1986;49:842–3.

    PubMed Central  PubMed  Google Scholar 

  • Edsbagge M, Tisell M, Jacobsson L, Wikkelso C. Spinal CSF absorption in healthy individuals. Am J Physiol Regul Integr Comp Physiol. 2004;287:R1450–5.

    CAS  PubMed  Google Scholar 

  • El Sankari S, Fichten A, Gondry-Jouet C, Czosnyka M, Legars D, Deramond H, Balédent O. Correlation between tap test and CSF aqueductal stroke volume in idiopathic normal pressure hydrocephalus. Acta Neurochir Suppl. 2012;113:43–6.

    PubMed  Google Scholar 

  • Esmonde T, Cooke S. Shunting for normal pressure hydrocephalus (NPH). Cochrane Database Syst Rev. 2002;(3):CD003157.

    Google Scholar 

  • Evans WA. An encephalographic ratio for estimating ventricular enlargement and cerebral atrophy. Arch Neurol Psychiatry. 1942;47:931–7.

    Google Scholar 

  • Fabiano AJ, Doyle K, Grand W. Delayed stoma failure in adult communicating hydrocephalus after initial successful treatment by endoscopic third ventriculostomy: case report. Neurosurgery. 2010;66:E1210–1.

    PubMed  Google Scholar 

  • Farahmand D, Hilmarsson H, Högfeldt M, Tisell M. Perioperative risk factors for short term shunt revisions in adult hydrocephalus patients. J Neurol Neurosurg Psychiatry. 2009;80:1248–53.

    CAS  PubMed  Google Scholar 

  • Fisher CM. Communicating hydrocephalus. Lancet. 1978;1(8054):37.

    CAS  PubMed  Google Scholar 

  • Fisher CM. Hydrocephalus as a cause of disturbances of gait in the elderly. Neurology. 1982;32:1358–63.

    CAS  PubMed  Google Scholar 

  • Fountas KN, Kapsalaki EZ, Paterakis KN, Lee GP, Hadjigeorgiou GM. Role of endoscopic third ventriculostomy in treatment of selected patients with normal pressure hydrocephalus. Acta Neurochir Suppl. 2012;113:129–33.

    PubMed  Google Scholar 

  • Freimann FB, Sprung C. Shunting with gravitational valves–can adjustments end the era of revisions for overdrainage-related events?: clinical article. J Neurosurg. 2012;117:1197–204.

    PubMed  Google Scholar 

  • Gallassi R, Morreale A, Montagna P, Sacquegna T, Di Sarro R, Lugaresi E. Binswanger’s disease and normal-pressure hydrocephalus. Clinical and neuropsychological comparison. Arch Neurol. 1991;48:1156–9.

    CAS  PubMed  Google Scholar 

  • Gangemi M, Maiuri F, Buonamassa S, Colella G, de Divitiis E. Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus. Neurosurgery. 2004;55:129–34.

    PubMed  Google Scholar 

  • Gangemi M, Maiuri F, Naddeo M, Godano U, Mascari C, Broggi G, Ferroli P. Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus: an Italian multicenter study. Neurosurgery. 2008;63:62–7.

    PubMed  Google Scholar 

  • Gawler J, Du Boulay GH, Bull JW, Marshall J. Computerized tomography (the EMI Scanner): a comparison with pneumoencephalography and ventriculography. J Neurol Neurosurg Psychiatry. 1976;39:203–11.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Goodman M, Meyer WJ. Dementia reversal in post-shunt normal pressure hydrocephalus predicted by neuropsychological assessment. J Am Geriatr Soc. 2001;49:685–6.

    CAS  PubMed  Google Scholar 

  • Greenberg JO, Shenkin HA, Adam R. Idiopathic normal pressure hydrocephalus– a report of 73 patients. J Neurol Neurosurg Psychiatry. 1977;40:336–41.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Greenfield JG. Lumbar puncture in diagnosis. Br Med J. 1935;2:1265–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Gunasekera L, Richardson AE. Computerized axial tomography in idiopathic hydrocephalus. Brain. 1977;100:749–54.

    CAS  PubMed  Google Scholar 

  • Hashimoto M, Ishikawa M, Mori E, Kuwana N, Study of INPH on neurological improvement (SINPHONI). Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res. 2010;7:18.

    PubMed Central  PubMed  Google Scholar 

  • Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA. Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol. 2003;60:1119–22.

    PubMed  Google Scholar 

  • Hellström P, Klinge P, Tans J, Wikkelsø C. A new scale for assessment of severity and outcome in iNPH. Acta Neurol Scand. 2012;126:229–37.

    PubMed  Google Scholar 

  • Hiraoka K, Meguro K, Mori E. Prevalence of idiopathic normal-pressure hydrocephalus in the elderly population of a Japanese rural community. Neurol Med Chir. 2008;48:197–9.

    Google Scholar 

  • Honda K, Matsumoto M, Kaneko T, Kamei I, Tatsumi H, Murai N, Mineharu Y, Oita J. Linear deposition of immunoglobulins and complement components on the dura in normal pressure hydrocephalus complicating systemic lupus erythematosus. J Clin Neurosci. 2004;11:561–3.

    PubMed  Google Scholar 

  • Iddon JL, Pickard JD, Cross JJ, Griffiths PD, Czosnyka M, Sahakian BJ. Specific patterns of cognitive impairment in patients with idiopathic normal pressure hydrocephalus and Alzheimer’s disease: a pilot study. J Neurol Neurosurg Psychiatry. 1999;67:723–32.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Ishii K, Kanda T, Harada A, Miyamoto N, Kawaguchi T, Shimada K, Ohkawa S, Uemura T, Yoshikawa T, Mori E. Clinical impact of the callosal angle in the diagnosis of idiopathic normal pressure hydrocephalus. Eur Radiol. 2008;18:2678–83.

    PubMed  Google Scholar 

  • Ishikawa M, Hashimoto M, Kuwana N, Mori E, Miyake H, Wachi A, Takeuchi T, Kazui H, Koyama H. Guidelines for management of idiopathic normal pressure hydrocephalus. Neurol Med Chir (Tokyo). 2008;48(Suppl):S1–23.

    PubMed  Google Scholar 

  • Jacobs L, Kinkel W. Computerized axial transverse tomography in normal pressure hydrocephalus. Neurology. 1976;26(6 PT1):501–7.

    CAS  PubMed  Google Scholar 

  • Johnston M. The importance of lymphatics in cerebrospinal fluid transport. Lymphat Res Biol. 2003;1:41–4.

    PubMed  Google Scholar 

  • Karabatsou K, Quigley G, Buxton N, Foy P, Mallucci C. Lumboperitoneal shunts: are the complications acceptable? Acta Neurochir (Wien). 2004;146:1193–7.

    CAS  Google Scholar 

  • Katzman R, Hussey F. A simple constant-infusion manometric test for measurement of CSF absorption. I. Rationale and method. Neurology. 1970;20:534–44.

    CAS  PubMed  Google Scholar 

  • Kaye JA, Grady CL, Haxby JV, Moore A, Friedland RP. Plasticity in the aging brain. Reversibility of anatomic, metabolic, and cognitive deficits in normal-pressure hydrocephalus following shunt surgery. Arch Neurol. 1990;47:1336–41.

    CAS  PubMed  Google Scholar 

  • Keucher TR, Mealey Jr J. Long-term results after ventriculoatrial and ventriculoperitoneal shunting for infantile hydrocephalus. J Neurosurg. 1979;50:179–86.

    CAS  PubMed  Google Scholar 

  • Kiefer M, Eymann R, Steudel WI. Outcome predictors for normal-pressure hydrocephalus. Acta Neurochir Suppl. 2006;96:364–7.

    CAS  PubMed  Google Scholar 

  • Kitagaki H, Mori E, Ishii K, Yamaji S, Hirono N, Imamura T. CSF spaces in idiopathic normal pressure hydrocephalus: morphology and volumetry. AJNR Am J Neuroradiol. 1998;19:1277–84.

    CAS  PubMed  Google Scholar 

  • Kito Y, Kazui H, Kubo Y, Yoshida T, Takaya M, Wada T, Nomura K, Hashimoto M, Ohkawa S, Miyake H, Ishikawa M, Takeda M. Neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus. Behav Neurol. 2009;21:165–74.

    PubMed  Google Scholar 

  • Klinge P, Marmarou A, Bergsneider M, Relkin N, Black PM. Outcome of shunting in idiopathic normal-pressure hydrocephalus and the value of outcome assessment in shunted patients. Neurosurgery. 2005;57(3 Suppl):S40–52.

    PubMed  Google Scholar 

  • Klinge P, Hellström P, Tans J, Wikkelsø C, European iNPH Multicentre Study Group. One-year outcome in the European multicentre study on iNPH. Acta Neurol Scand. 2012;126:145–53.

    CAS  PubMed  Google Scholar 

  • Koch HJ, Nanev D, Becker K. Acute behaviour disorder in a patient with X-linked hydrocephalus with normal pressure. Wien Med Wochenschr. 2009;159:62–4.

    PubMed  Google Scholar 

  • Koivisto AM, Alafuzoff I, Savolainen S, Sutela A, Rummukainen J, Kurki M, Jääskeläinen JE, Soininen H, Rinne J, Leinonen V. Poor cognitive outcome in shunt-responsive idiopathic normal pressure hydrocephalus. Neurosurgery. 2013;72:1–8.

    PubMed  Google Scholar 

  • Krauss JK, Halve B. Normal pressure hydrocephalus. survey on contemporary diagnostic algorithms and therapeutic decision-making in clinical practice. Acta Neurochir. 2004;146:379–88.

    CAS  PubMed  Google Scholar 

  • Kubo Y, Kazui H, Yoshida T, Kito Y, Kimura N, Tokunaga H, Ogino A, Miyake H, Ishikawa M, Takeda M. Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus. Dement Geriatr Cogn Disord. 2008;25:37–45.

    PubMed  Google Scholar 

  • Kwentus JA, Hart RP. Normal pressure hydrocephalus presenting as mania. J Nerv Ment Dis. 1987;175:500–2.

    CAS  PubMed  Google Scholar 

  • Lam CH, Villemure JG. Comparison between ventriculoatrial and ventriculoperitoneal shunting in the adult population. Br J Neurosurg. 1997;11:43–8.

    CAS  PubMed  Google Scholar 

  • Larsson A, Wikkelsö C, Bilting M, Stephensen H. Clinical parameters in 74 consecutive patients shunt operated for normal pressure hydrocephalus. Acta Neurol Scand. 1991;84:475–82.

    CAS  PubMed  Google Scholar 

  • Lemcke J, Meier U. Improved outcome in shunted iNPH with a combination of a Codman Hakim programmable valve and an Aesculap-Miethke Shunt Assistant. Cent Eur Neurosurg. 2010;71:113–6.

    CAS  PubMed  Google Scholar 

  • Lemcke J, Meier U. Idiopathic normal pressure hydrocephalus (iNPH) and co-morbidity: an outcome analysis of 134 patients. Acta Neurochir Suppl. 2012;114:255–9.

    PubMed  Google Scholar 

  • Lemcke J, Meier U, Müller C, Fritsch MJ, Kehler U, Langer N, Kiefer M, Eymann R, Schuhmann MU, Speil A, Weber F, Remenez V, Rohde V, Ludwig HC, Stengel D. Safety and efficacy of gravitational shunt valves in patients with idiopathic normal pressure hydrocephalus: a pragmatic, randomised, open label, multicentre trial (SVASONA). J Neurol Neurosurg Psychiatry. 2013;84:850–7.

    PubMed Central  PubMed  Google Scholar 

  • Lenfeldt N, Hauksson J, Birgander R, Eklund A, Malm J. Improvement after cerebrospinal fluid drainage is related to levels of N-acetyl-aspartate in idiopathic normal pressure hydrocephalus. Neurosurgery. 2008a;62:135–41.

    PubMed  Google Scholar 

  • Lenfeldt N, Larsson A, Nyberg L, Andersson M, Birgander R, Eklund A, Malm J. Idiopathic normal pressure hydrocephalus: increased supplementary motor activity accounts for improvement after CSF drainage. Brain. 2008b;131:2904–12.

    PubMed  Google Scholar 

  • Lenfeldt N, Hansson W, Larsson A, Birgander R, Eklund A, Malm J. Three-day CSF drainage barely reduces ventricular size in normal pressure hydrocephalus. Neurology. 2012;79:237–42.

    PubMed  Google Scholar 

  • Longatti PL, Fiorindi A, Martinuzzi A. Failure of endoscopic third ventriculostomy in the treatment of idiopathic normal pressure hydrocephalus. Minim Invasive Neurosurg. 2004;47:342–5.

    CAS  PubMed  Google Scholar 

  • Luedemann W, Kondziella D, Tienken K, Klinge P, Brinker T, Berens von Rautenfeld D. Spinal cerebrospinal fluid pathways and their significance for the compensation of kaolin-hydrocephalus. Acta Neurochir Suppl. 2002;81:271–3.

    CAS  PubMed  Google Scholar 

  • MacCordick AH. Observations on the value of lumbar puncture. Can Med Assoc J. 1922;12:168–70.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Malm J, Lundkvist B, Eklund A, Koskinen LO, Kristensen B. CSF outflow resistance as predictor of shunt function. A long-term study. Acta Neurol Scand. 2004;110:154–60.

    CAS  PubMed  Google Scholar 

  • Malm J, Graff-Radford NR, Ishikawa M, Kristensen B, Leinonen V, Mori E, Owler BK, Tullberg M, Williams MA, Relkin NR. Influence of comorbidities in idiopathic normal pressure hydrocephalus – research and clinical care. A report of the ISHCSF task force on comorbidities in INPH. Fluids Barriers CNS. 2013;10:22.

    PubMed Central  PubMed  Google Scholar 

  • Marmarou A, Bergsneider M, Klinge P, Relkin N, Black PM. The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005a;57(3 Suppl):S17–28.

    PubMed  Google Scholar 

  • Marmarou A, Bergsneider M, Relkin N, Klinge P, Black PM. Development of guidelines for idiopathic normal-pressure hydrocephalus: introduction. Neurosurgery. 2005b;57(3 Suppl):S1–3.

    PubMed  Google Scholar 

  • Marmarou A, Young HF, Aygok GA. Estimated incidence of normal pressure hydrocephalus and shunt outcome in patients residing in assisted-living and extended-care facilities. Neurosurg Focus. 2007;22:E1.

    Google Scholar 

  • Martin BJ, Roberts MA, Turner JW. Normal pressure hydrocephalus and Paget’s disease of bone. Gerontology. 1985;31:397–402.

    CAS  PubMed  Google Scholar 

  • Matera R, Althabe BM. Continuous lumbar drainage of the cerebrospinal fluid in neurosurgery. Sem Med. 1962;121:1083–7.

    CAS  PubMed  Google Scholar 

  • Matousek M, Wikkelsö C, Blomsterwall E, Johnels B, Steg G. Motor performance in normal pressure hydrocephalus assessed with an optoelectronic measurement technique. Acta Neurol Scand. 1995;91:500–5.

    CAS  PubMed  Google Scholar 

  • Matson DD. A new operation for the treatment of communicating hydrocephalus: report of a case secondary to generalized meningitis. J Neurosurg. 1949;6:238–47.

    CAS  PubMed  Google Scholar 

  • Mazza C, Pasqualin A, Da Pian R. Results of treatment with ventriculoatrial and ventriculoperitoneal shunt in infantile nontumoral hydrocephalus. Childs Brain. 1980;7:1–14.

    CAS  PubMed  Google Scholar 

  • McConnell KA, Zou KH, Chabrerie AV, Bailey NO, Black PM. Decreases in ventricular volume correlate with decreases in ventricular pressure in idiopathic normal pressure hydrocephalus patients who experienced clinical improvement after implantation with adjustable valve shunts. Neurosurgery. 2004;55:582–92.

    PubMed Central  PubMed  Google Scholar 

  • McGirr A, Cusimano MD. Familial aggregation of idiopathic normal pressure hydrocephalus: novel familial case and a family study of the NPH triad in an iNPH patient cohort. J Neurol Sci. 2012;321:82–8.

    PubMed  Google Scholar 

  • McHugh PR. Occult hydrocephalus. Q J Med. 1964;33:297–308.

    CAS  PubMed  Google Scholar 

  • Megison DP, Benzel EC. Ventriculo-pleural shunting for adult hydrocephalus. Br J Neurosurg. 1988;2:503–5.

    CAS  PubMed  Google Scholar 

  • Meier U, Lemcke J. Clinical outcome of patients with idiopathic normal pressure hydrocephalus three years after shunt implantation. Acta Neurochir Suppl. 2006;96:377–80.

    CAS  PubMed  Google Scholar 

  • Meier U, Lemcke J. The influence of co-morbidity on the postoperative outcomes of patients with idiopathic normal pressure hydrocephalus (iNPH). Acta Neurochir Suppl. 2008;102:141–4.

    CAS  PubMed  Google Scholar 

  • Meier U, Lemcke J. Co-morbidity as a predictor of outcome in patients with idiopathic normal-pressure hydrocephalus. Acta Neurochir Suppl. 2010;106:127–30.

    PubMed  Google Scholar 

  • Meier U, Paris S, Gräwe A, Stockheim D, Hajdukova A, Mutze S. Is there a correlation between operative results and change in ventricular volume after shunt placement? A study of 60 cases of idiopathic normal-pressure hydrocephalus. Neuroradiology. 2003;45:377–80.

    CAS  PubMed  Google Scholar 

  • Mirzayan MJ, Luetjens G, Borremans JJ, Regel JP, Krauss JK. Extended long-term (> 5 years) outcome of cerebrospinal fluid shunting in idiopathic normal pressure hydrocephalus. Neurosurgery. 2010;67:295–301.

    PubMed  Google Scholar 

  • Missori P, Paolini S, Currà A. From congenital to idiopathic adult hydrocephalus: a historical research. Brain. 2010;133:1836–49.

    PubMed  Google Scholar 

  • Missori P, Paolini S, Domenicucci M. The origin of the cannula for ventriculostomy in pediatric hydrocephalus. J Neurosurg Pediatr. 2011;7:290–4.

    PubMed  Google Scholar 

  • Moiyadi AV, Praharaj SS, Pillai VS, Chandramouli BA. Hydrocephalus in Paget’s disease. Acta Neurochir (Wien). 2006;148:1297–300.

    CAS  Google Scholar 

  • Mollanji R, Bozanovic-Sosic R, Zakharov A, Makarian L, Johnston MG. Blocking cerebrospinal fluid absorption through the cribriform plate increases resting intracranial pressure. Am J Physiol Regul Integr Comp Physiol. 2002;282:R1593–9.

    CAS  PubMed  Google Scholar 

  • Murakami M, Morine M, Iwasa T, Takahashi Y, Miyamoto T, Hon PK, Nakagawa Y. Management of maternal hydrocephalus requires replacement of ventriculoperitoneal shunt with ventriculoatrial shunt: a case report. Arch Gynecol Obstet. 2010;282:339–42.

    PubMed  Google Scholar 

  • Naruse H, Matsuoka Y. Post-operative improvement of 14 cases who were considered iNPH despite Evans’ index of 0.3 or less. No Shinkei Geka. 2013;41:25–30.

    PubMed  Google Scholar 

  • Nulsen F, Spitz EB. Treatment of hydrocephalus by direct shunt from ventricle to jugular vein. Surg Forum. 1951;2:399–409.

    Google Scholar 

  • Olsen L, Frykberg T. Complications in the treatment of hydrocephalus in children. A comparison of ventriculoatrial and ventriculoperitoneal shunts in a 20-year material. Acta Paediatr Scand. 1983;72:385–90.

    CAS  PubMed  Google Scholar 

  • Palm WM, Walchenbach R, Bruinsma B, Admiraal-Behloul F, Middelkoop HA, Launer LJ, van der Grond J, van Buchem MA. Intracranial compartment volumes in normal pressure hydrocephalus: volumetric assessment versus outcome. AJNR Am J Neuroradiol. 2006;27:76–9.

    CAS  PubMed  Google Scholar 

  • Patwardhan RV, Nanda A. Implanted ventricular shunts in the United States: the billion-dollar-a-year cost of hydrocephalus treatment. Neurosurgery. 2005;56:139–44.

    PubMed  Google Scholar 

  • Pinto FC, Saad F, Oliveira MF, Pereira RM, Miranda FL, Tornai JB, Lopes MI, Ribas ES, Valinetti EA, Teixeira MJ. Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. Neurosurgery. 2013;72:845–54.

    PubMed  Google Scholar 

  • Poca MA, Mataró M, Del Mar Matarín M, Arikan F, Junqué C, Sahuquillo J. Is the placement of shunts in patients with idiopathic normal-pressure hydrocephalus worth the risk? Results of a study based on continuous monitoring of intracranial pressure. J Neurosurg. 2004;100:855–66.

    PubMed  Google Scholar 

  • Portenoy RK, Berger A, Gross E. Familial occurrence of idiopathic normal-pressure hydrocephalus. Arch Neurol. 1984;41:335–7.

    CAS  PubMed  Google Scholar 

  • Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM. Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005;57:S4–16.

    PubMed  Google Scholar 

  • Rhodes H. The value of lumbar puncture in general practice. Br Med J. 1903;2:73–4.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Rice E, Gendelman S. Psychiatric aspects of normal pressure hydrocephalus. JAMA. 1973;223:409–12.

    CAS  PubMed  Google Scholar 

  • Riggs JE, Rubenstein MN, Gutmann L. Myotonic dystrophy and normal-pressure hydrocephalus. Neurology. 1985;35:1535.

    CAS  PubMed  Google Scholar 

  • Roger H, Paillas J, Roger J, Tamalet J. Grande hydrocéphalie latente du vieillard chez une démente artérioscléreuse. Rev Neurol. 1950;82:437–8.

    CAS  PubMed  Google Scholar 

  • Roohi F, Mann D, Kula RW. Surgical management of hydrocephalic dementia in Paget’s disease of bone: the 6-year outcome of ventriculo-peritoneal shunting. Clin Neurol Neurosurg. 2005;107:325–8.

    PubMed  Google Scholar 

  • Saito M, Nishio Y, Kanno S, Uchiyama M, Hayashi A, Takagi M, Kikuchi H, Yamasaki H, Shimomura T, Iizuka O, Mori E. Cognitive profile of idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Dis Extra. 2011;1:202–11.

    PubMed Central  PubMed  Google Scholar 

  • Sakakibara R, Kanda T, Sekido T, Uchiyama T, Awa Y, Ito T, Liu Z, Yamamoto T, Yamanishi T, Yuasa T, Shirai K, Hattori T. Mechanism of bladder dysfunction in idiopathic normal pressure hydrocephalus. Neurourol Urodyn. 2008;27:507–10.

    PubMed  Google Scholar 

  • Sakakibara R, Uchida Y, Ishii K, Kazui H, Hashimoto M, Ishikawa M, Yuasa T, Kishi M, Ogawa E, Tateno F, Uchiyama T, Yamamoto T, Yamanishi T, Terada H. Correlation of right frontal hypoperfusion and urinary dysfunction in iNPH: a SPECT study. Neurourol Urodyn. 2012;31:50–5.

    PubMed  Google Scholar 

  • Sasaki M, Honda S, Yuasa T, Iwamura A, Shibata E, Ohba H. Narrow CSF space at high convexity and high midline areas in idiopathic normal pressure hydrocephalus detected by axial and coronal MRI. Neuroradiology. 2008;50:117–22.

    PubMed  Google Scholar 

  • Savitz MH, Bobroff LM. Low incidence of delayed intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion. J Neurosurg. 1999;91:32–4.

    CAS  PubMed  Google Scholar 

  • Scollato A, Gallina P, Gautam B, Pellicanò G, Cavallini C, Tenenbaum R, Di Lorenzo N. Changes in aqueductal CSF stroke volume in shunted patients with idiopathic normal-pressure hydrocephalus. AJNR Am J Neuroradiol. 2009;30:1580–6.

    CAS  PubMed  Google Scholar 

  • Shenkin HA, Greenberg JO, Grossman CB. Ventricular size after shunting for idiopathic normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry. 1975;38:833–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Silverberg GD, Mayo M, Saul T, Rubenstein E, McGuire D. Alzheimer’s disease, normal-pressure hydrocephalus, and senescent changes in CSF circulatory physiology: a hypothesis. Lancet Neurol. 2003;2:506–11.

    PubMed  Google Scholar 

  • Singer OC, Melber J, Hattingen E, Jurcoane A, Keil F, Neumann-Haefelin T, Klein JC. MR volumetric changes after diagnostic CSF removal in normal pressure hydrocephalus. J Neurol. 2012;259:2440–6.

    PubMed  Google Scholar 

  • Stolze H, Kuhtz-Buschbeck JP, Drücke H, Jöhnk K, Diercks C, Palmié S, Mehdorn HM, Illert M, Deuschl G. Gait analysis in idiopathic normal pressure hydrocephalus–which parameters respond to the CSF tap test? Clin Neurophysiol. 2000;111:1678–86.

    CAS  PubMed  Google Scholar 

  • Stranjalis G, Kalamatianos T, Koutsarnakis C, Loufardaki M, Stavrinou L, Sakas DE. Twelve-year hospital outcomes in patients with idiopathic hydrocephalus. Acta Neurochir Suppl. 2012;113:115–7.

    PubMed  Google Scholar 

  • Suzuchi H, Matsubara T, Kanamaru K, Kojima T. Chronic hydrocephalus presenting with bilateral ptosis after minor head injury: case report. Neurosurgery. 2000;47:977–9.

    Google Scholar 

  • Synek V, Reuben JR, Du Boulay GH. Comparing Evans’ index and computerized axial tomography in assessing relationship of ventricular size to brain size. Neurology. 1976;26:231–3.

    CAS  PubMed  Google Scholar 

  • Takahashi Y, Kawanami T, Nagasawa H, Iseki C, Hanyu H, Kato T. Familial normal pressure hydrocephalus (NPH) with an autosomal-dominant inheritance: a novel subgroup of NPH. J Neurol Sci. 2011;308:149–51.

    PubMed  Google Scholar 

  • Tanaka N, Yamaguchi S, Ishikawa H, Ishii H, Meguro K. Prevalence of possible idiopathic normal-pressure hydrocephalus in Japan: the Osaki-Tajiri project. Neuroepidemiology. 2009;32:171–5.

    PubMed  Google Scholar 

  • Taylor AE, Saint-Cyr JA, Lang AE. Frontal lobe dysfunction in Parkinson’s disease. The cortical focus of neostriatal outflow. Brain. 1986;109:845–83.

    PubMed  Google Scholar 

  • Tisell M, Hoglund M, Wikkelso C. National and regional incidence of surgery for adult hydrocephalus in Sweden. Acta Neurol Scand. 2005;112:72–5.

    CAS  PubMed  Google Scholar 

  • Toma AK, Holl E, Kitchen ND, Watkins LD. Evans’ index revisited: the need for an alternative in normal pressure hydrocephalus. Neurosurgery. 2011a;68:939–44.

    PubMed  Google Scholar 

  • Toma AK, Stapleton S, Papadopoulos MC, Kitchen ND, Watkins LD. Natural history of idiopathic normal-pressure hydrocephalus. Neurosurg Rev. 2011b;34:433–9.

    PubMed  Google Scholar 

  • Toma AK, Papadopoulos MC, Stapleton S, Kitchen ND, Watkins LD. Conservative versus surgical management of idiopathic normal pressure hydrocephalus: a prospective double-blind randomized controlled trial: study protocol. Acta Neurochir Suppl. 2012;113:21–3.

    PubMed  Google Scholar 

  • Trenkwalder C, Schwarz J, Gebhard J, Ruland D, Trenkwalder P, Hense HW, Oertel WH. Starnberg trial on epidemiology of Parkinsonism and hypertension in the elderly. Prevalence of Parkinson’s disease and related disorders assessed by a door-to-door survey of inhabitants older than 65 years. Arch Neurol. 1995;52:1017–22.

    CAS  PubMed  Google Scholar 

  • Vanneste J, Augustijn P, Tan WF, Dirven C. Shunting normal pressure hydrocephalus: the predictive value of combined clinical and CT data. J Neurol Neurosurg Psychiatry. 1993;56:251–6.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Vernet O, Campiche R, de Tribolet N. Long-term results after ventriculoatrial shunting in children. Childs Nerv Syst. 1993;9:253–5.

    CAS  PubMed  Google Scholar 

  • Virhammar J, Cesarini KG, Laurell K. The CSF tap test in normal pressure hydrocephalus: evaluation time, reliability and the influence of pain. Eur J Neurol. 2012;19:271–6.

    CAS  PubMed  Google Scholar 

  • von Ziemssen HW. Paracentesis of the spinal dura. Epitome of current medical literature. Br Med J. 1893;1:81.

    Google Scholar 

  • Vourc’h G. Continuous cerebrospinal fluid drainage by indwelling spinal catheter. Br J Anaesth. 1963;35:118–20.

    PubMed  Google Scholar 

  • Vourc’h G, Rougerie J. Continuous drainage of the cerebrospinal fluid. New method by the installation of a permanent spinal catheter. Its value in neurosurgery. Presse Med. 1960;68:1491–2.

    PubMed  Google Scholar 

  • Wang VY, Barbaro NM, Lawton MT, Pitts L, Kunwar S, Parsa AT, Gupta N, McDermott MW. Complications of lumboperitoneal shunts. Neurosurgery. 2007;60:1045–8.

    PubMed  Google Scholar 

  • Westhout FD, Linskey ME. Obstructive hydrocephalus and progressive psychosis: rare presentations of neurosarcoidosis. Surg Neurol. 2008;69:288–92.

    PubMed  Google Scholar 

  • Wikkelsø C, Andersson H, Blomstrand C, Lindqvist G. The clinical effect of lumbar puncture in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry. 1982;45:64–9.

    PubMed Central  PubMed  Google Scholar 

  • Wikkelsø C, Hellström P, Klinge PM, Tans JT. The European iNPH Multicentre Study on the predictive values of resistance to CSF outflow and the CSF Tap Test in patients with idiopathic normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry. 2013;84:562–8.

    PubMed  Google Scholar 

  • Wright EM. Transport processes in the formation of the cerebrospinal fluid. Rev Physiol Biochem Pharmacol. 1978;83:3–34.

    CAS  PubMed  Google Scholar 

  • Wynter WE. Four cases of tubercular meningitis in which paracentesis was performed for the relief of fluid pressure. Lancet. 1891;1:981–2.

    Google Scholar 

  • Yadav YR, Parihar V, Sinha M. Lumbar peritoneal shunt. Neurol India. 2010;58:179–84.

    PubMed  Google Scholar 

  • Yusim A, Anbarasan D, Bernstein C, Boksay I, Dulchin M, Lindenmayer JP, Saavedra-Velez C, Shapiro M, Sadock B. Normal pressure hydrocephalus presenting as Othello syndrome: case presentation and review of the literature. Am J Psychiatry. 2008;165:1119–25.

    PubMed  Google Scholar 

  • Zemack G, Romner B. Seven years of clinical experience with the programmable Codman Hakim valve: a retrospective study of 583 patients. J Neurosurg. 2000;92:941–8.

    CAS  PubMed  Google Scholar 

  • Zemack G, Romner B. Adjustable valves in normal-pressure hydrocephalus: a retrospective study of 218 patients. Neurosurgery. 2008;62 Suppl 2:677–87.

    PubMed  Google Scholar 

  • Zhang J, Qu C, Wang Z, Wang C, Ding X, Pan S, Ji Y. Improved ventriculoatrial shunt for cerebrospinal fluid diversion after multiple ventriculoperitoneal shunt failures. Surg Neurol. 2009;72 Suppl 1:S29–33.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology and Psychiatry, Policlinico “Umberto I”, “Sapienza” University of Rome, Rome, Italy

    Paolo Missori MD

  2. Institute of Neurology, Policlinico “A. Gemelli”, Catholic University of the Sacred Heart, Rome, Italy

    Antonio Daniele MD, PhD

  3. Department of Neurology and Psychiatry, “Sapienza” University of Rome, Rome, Italy

    Carlo Colosimo MD

Authors
  1. Paolo Missori MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Daniele MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carlo Colosimo MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Missori MD .

Editor information

Editors and Affiliations

  1. Neuroscience Department, Universidad Catolica Argentina, Buenos Aires, Argentina

    Marcelo Merello

  2. Psychiatry and Clinical Neurosciences, University of Western Australia, Fremantle, Australia

    Sergio E. Starkstein

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Missori, P., Daniele, A., Colosimo, C. (2014). Normal Pressure Hydrocephalus. In: Merello, M., Starkstein, S. (eds) Movement Disorders in Dementias. Springer, London. https://doi.org/10.1007/978-1-4471-6365-7_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6365-7_14

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6364-0

  • Online ISBN: 978-1-4471-6365-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation