[Hypertensive vasculopathy as a causative factor of normal pressure hydrocephalus--a clinical analysis (author's...

Eighteen subjects, who were diagnosed as idiopathic normal pressure hydrocephalus in our outer patient clinic, were undergone with CT scan, metrizamide CT cisternography (CTC), radioisotope cisternography (RIC), and they were classified into 3 groups in accordance with ischemic score which had been proposed by Hachinski. Ventriculoperitoneal shunt was performed in 17 subjects, but improvement of the symptoms were obtained only in five. Dementia, gait disturbance and urinary incontinence were common features among the ones who had clinical improvement after shunt and the ones who had not, but systemic arterial hypertension and focal ischemic signs were more frequently found in formers than in latters. The subjects with low ischemic score were classified into Group 1, and the one with high ischemic score were classified into Group 2 and the other one with moderate score were into Group 3. The subjects who had clinical improvement postoperatively were exclusively found in Group 2 and 3. If the degree of ischemic score has good correlation with actual existence of cerebral ischemic lesions, we might suspect from our data that systemic arterial hypertension and ischemic lesion of the cerebrum might be basic pathologies which develop an idiopathic normal pressure hydrocephalus.