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Normal Pressure Hydrocephalus.

Neill R Graff-Radford, David T Jones

    Continuum (Minneapolis, Minn.)
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    Summary
    This summary is machine-generated.

    Normal pressure hydrocephalus (NPH) is rare but presents with enlarged ventricles in aging. Advances in neuroimaging and objective scales improve diagnosis and treatment outcomes for NPH patients.

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    Area of Science:

    • Neurology
    • Neurosurgery
    • Radiology

    Background:

    • Normal pressure hydrocephalus (NPH) remains controversial despite recent advances.
    • Epidemiology and pathogenesis are better understood, with improved outcome measures.
    • Neuroimaging aids in NPH recognition and identification of overlapping conditions.

    Purpose of the Study:

    • To review recent findings in NPH epidemiology, pathogenesis, and diagnosis.
    • To highlight advancements in neuroimaging and objective outcome assessment.
    • To discuss the recognition and management of NPH and co-occurring diseases.

    Main Methods:

    • Review of recent epidemiologic studies on NPH prevalence.
    • Analysis of MRI features, including disproportionately enlarged subarachnoid space hydrocephalus (DESH).
    • Evaluation of new diagnostic scales and surgical outcome data.

    Main Results:

    • NPH is rare, but enlarged ventricles are common in aging.
    • MRI findings like DESH aid in prognostication.
    • New scales and programmable shunts improve patient evaluation and management.
    • Overlapping diseases, such as Alzheimer's, occur in ~30% of NPH cases.
    • FDG-PET shows promise for diagnosing NPH and co-existing conditions.

    Conclusions:

    • A systematic approach aids in identifying NPH patients who will benefit from shunt surgery.
    • Recognition of alternative diagnoses is crucial for effective patient management.