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Revisiting secondary normal pressure hydrocephalus: does it exist? A review
Badih Daou1, Petra Klinge2, Stavropoula Tjoumakaris1
1Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; and.
Neurosurgical Focus
|September 2, 2016
Summary
Secondary normal pressure hydrocephalus (sNPH) is often caused by subarachnoid hemorrhage or head trauma. Shunt placement improved outcomes in most patients with sNPH, with higher success rates for specific etiologies.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Secondary normal pressure hydrocephalus (sNPH) arises from various underlying causes.
- Understanding these etiologies is crucial for diagnosis and treatment.
Purpose of the Study:
- To evaluate the causes, diagnosis, treatment, and outcomes of sNPH.
- To identify differences in outcomes based on the etiology of sNPH.
Main Methods:
- A literature review of 64 studies (1965-2015) including 1309 patients with sNPH.
- Data extraction on etiology, diagnosis, treatment, and clinical improvement using grading scales.
Main Results:
- Subarachnoid hemorrhage (46.5%) and head trauma (29%) were the most common causes of sNPH.
- Ventriculoperitoneal shunts were used in 71.9% of cases, with 74.4% reporting clinical improvement.
- Outcomes varied by etiology, with subarachnoid hemorrhage and head trauma showing high improvement rates.
Conclusions:
- Secondary NPH is a distinct entity from idiopathic NPH, with identifiable causes and varied outcomes.
- Subarachnoid hemorrhage and traumatic brain injury are primary etiologies.
- While distinct, sNPH should be considered within the spectrum of acquired hydrocephalus.
Keywords:
CVD = cerebrovascular diseaseICH = intracerebral hemorrhageICP = intracranial pressureLP = lumboperitonealNPHNPH, iNPH, sNPH = normal pressure hydrocephalus, idiopathic NPH, secondary NPHSAH = subarachnoid hemorrhageVA = ventriculoatrialVP = ventriculoperitonealnormal pressure hydrocephalussecondary
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