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[Idiopathic normal pressure hydrocephalus--overviews and pathogenesis].
1Department of Neurosurgery, Kitano Hospital, Kita-ku, Osaka 530 8480, Japan.
Brain and Nerve = Shinkei Kenkyu No Shinpo
|April 12, 2008
Summary
Idiopathic normal pressure hydrocephalus (iNPH) is a common elderly syndrome. Japanese guidelines focus on gait disturbance, using CSF tap tests for shunt surgery in probable iNPH cases.
Area of Science:
- Neurology
- Geriatrics
- Neurosurgery
Context:
- Idiopathic normal pressure hydrocephalus (iNPH) is a significant neurological syndrome in the elderly.
- The aging population in Japan necessitates clear diagnostic and management guidelines for iNPH.
- Existing guidelines aim for simplicity and treatment orientation.
Purpose:
- To present the key features of the Japanese guidelines for diagnosing and managing iNPH.
- To compare the Japanese guidelines with international evidence-based guidelines.
- To highlight differences in diagnostic approaches and criteria.
Summary:
- The Japanese guidelines emphasize gait disturbance as a primary symptom and the CSF tap test as a crucial diagnostic step.
- Shunt surgery is recommended only for probable iNPH cases.
- Guidelines include flow-charts for diagnosis, surgical indications, and complication prevention, recommending programmable valves.
Impact:
- Facilitates standardized diagnosis and treatment of iNPH in Japan.
- Provides a framework for managing gait disturbance, dementia, and urinary incontinence in iNPH patients.
- Contributes to the ongoing discussion and refinement of iNPH diagnostic criteria globally.
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