The Experts below are selected from a list of 306 Experts worldwide ranked by ideXlab platform
Elnamarie Larsson - One of the best experts on this subject based on the ideXlab platform.
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preoperative prognostic value of mri findings in 108 patients with idiopathic Normal Pressure Hydrocephalus
American Journal of Neuroradiology, 2014Co-Authors: Johan Virhammar, Katarina Laurell, Kristina Giuliana Cesarini, Elnamarie LarssonAbstract:BACKGROUND AND PURPOSE: MR imaging is used in the diagnostic evaluation of patients with idiopathic Normal Pressure Hydrocephalus. The aim of this study was to describe the prevalence of several im ...
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the callosal angle measured on mri as a predictor of outcome in idiopathic Normal Pressure Hydrocephalus
Journal of Neurosurgery, 2014Co-Authors: Johan Virhammar, Katarina Laurell, Kristina Giuliana Cesarini, Elnamarie LarssonAbstract:Object Different neuroimaging biomarkers have been studied to find a tool for prediction of response to CSF shunting in idiopathic Normal-Pressure Hydrocephalus (iNPH). The callosal angle (CA) has ...
Laurence D Watkins - One of the best experts on this subject based on the ideXlab platform.
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systematic review of the outcome of shunt surgery in idiopathic Normal Pressure Hydrocephalus
Acta Neurochirurgica, 2013Co-Authors: Ahmed K Toma, Simon Stapleton, Marios C Papadopoulos, Neil Kitchen, Laurence D WatkinsAbstract:Introduction Early surgical series of shunt insertion for idiopathic Normal-Pressure Hydrocephalus reported a low rate of short-term improvement with a relatively high rate of mortality and morbidity; subsequently shunt insertion was recommended for patients in whom there is favourable risk-to-benefit ratio.
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natural history of idiopathic Normal Pressure Hydrocephalus
Neurosurgical Review, 2011Co-Authors: Ahmed K Toma, Simon Stapleton, Marios C Papadopoulos, Neil Kitchen, Laurence D WatkinsAbstract:Natural history of idiopathic Normal-Pressure Hydrocephalus (INPH) is not clear. We performed a literature search for studies that looked into the outcome of unshunted INPH patients trying to answer the following questions: Do all INPH patients deteriorate without shunt? If yes, at what rate? Do some NPH patients improve without shunt? If yes, to what extent? Six studies objectively described the outcome of 102 INPH patients. Result shows that without surgery, most INPH patients had measurable deterioration as early as 3 months following initial assessment. A small number of patients might improve without shunt, however the extent of improvement is not clear. The homogeneity of the findings of the cohort studies provided high evidence supporting the rule of shunt surgery in INPH patients.
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The longitudinal profile of CSF markers during external lumbar drainage in idiopathic Normal Pressure Hydrocephalus
Journal of Neurology Neurosurgery and Psychiatry, 2009Co-Authors: Andrew Tarnaris, Ahmed Toma, Miles D Chapman, A Petzold, Neil D Kitchen, Geoffrey Keir, Laurence D WatkinsAbstract:External lumbar drainage (ELD) is known as a good predictor of favourable outcome in shunting patients suffering from idiopathic Normal Pressure Hydrocephalus (iNPH). To date there has been no study to investigate the changes occurring in the CSF composition of patients undergoing (ELD).
Peter Mcl Black - One of the best experts on this subject based on the ideXlab platform.
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techniques and complications of external lumbar drainage for Normal Pressure Hydrocephalus
Operative Neurosurgery, 2008Co-Authors: Lance S Governale, Nicole Fein, Jessica Logsdon, Peter Mcl BlackAbstract:OBJECTIVETo describe our system of external lumbar drainage for Normal Pressure Hydrocephalus, detail its complications, and discuss changes made to that system with time.METHODSThis is a retrospective analysis of lumbar drainage in 233 consecutive patients with symptoms treated at the Brigham and W
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techniques and complications of external lumbar drainage for Normal Pressure Hydrocephalus commentary
Neurosurgery, 2008Co-Authors: Lance S Governale, Peter Mcl Black, Nicole Fein, Jessica Logsdon, Ivan Ciric, Eric L ZagerAbstract:OBJECTIVE: To describe our system of external lumbar drainage for Normal Pressure Hydrocephalus, detail its complications, and discuss changes made to that system with time. METHODS: This is a retrospective analysis of lumbar drainage in 233 consecutive patients with symptoms treated at the Brigham and Women's Hospital, Boston, MA, from February 2002 to August 2006. RESULTS: The lumbar drain was successfully placed at the bedside in 223 of 233 patients; fluoroscopic guidance was used in 10 cases. There were significant complications in 3.0% of patients, including symptomatic subdural or subarachnoid hemorrhage in 1.7%, meningitis in 0.8%, and retained catheter in 0.4%. Another 5.2% of patients had minor problems, including nerve root irritation in 2.6%, low-Pressure headache substantial enough to warrant premature removal of the drain in 1.7%, and local infection in 0.8%. CONCLUSION: The rate of serious complications from external lumbar drainage for Normal Pressure Hydrocephalus is low. It is hoped that continued evaluation of the propcedure will lead to further reductions in the complication rate.
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surgical management of idiopathic Normal Pressure Hydrocephalus
Neurosurgery, 2005Co-Authors: Marvin Bergsneider, Petra M Klinge, Anthony Marmarou, Peter Mcl Black, Norman RelkinAbstract:Objective To develop evidence-based guidelines for surgical management of idiopathic Normal-Pressure Hydrocephalus (INPH). Compared with the diagnostic phase, the surgical management of INPH has received less scientific attention. The quality of much of the literature concerning the surgical management has been limited by many factors. These include retrospective analysis, small patient numbers, analysis of a mixed NPH population, and sometimes a lack of detail as to what type of shunt system was used. Many earlier studies predated our current understanding of the hydrodynamics of cerebrospinal fluid shunts, and therefore, the conclusions drawn may no longer be valid. Methods A MEDLINE and PubMed search from 1966 to the present was conducted using the following key terms: Normal-Pressure Hydrocephalus and idiopathic adult-onset Hydrocephalus. Only English-language literature in peer-reviewed journals was reviewed. The search was further limited to articles that described the method of treatment and outcome selectively for INPH patients. Finally, only studies that included 20 or more INPH patients were considered with respect to formulating the recommendations in these Guidelines (27 articles). Results For practical reasons, it is important to identify probable shunt responders diagnosed with INPH. If the patient is an acceptable candidate for anesthesia, then an INPH-specific risk-benefit analysis should be determined. In general, patients exhibiting negligible symptoms may not be suitable candidates for surgical management, given the known risks and complications associated with shunting INPH. The choice of valve type and setting should be based on empirical reasoning and a basic understanding of shunt hydrodynamics. The most conservative choice is a valve incorporating an antisiphon device, with the understanding that underdrainage (despite a low opening Pressure) may occur in a small percentage of patients because of the antisiphon device. On the basis of retrospective studies, the use of an adjustable valve seems to be beneficial in the management of INPH. Conclusion The treatment of INPH should not be considered lightly, given the seriousness of the potential complications. Within these limitations and the available evidence, guidelines for surgical management were developed.
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Diagnosing Idiopathic Normal-Pressure Hydrocephalus
Neurosurgery, 2005Co-Authors: Norman Relkin, Anthony Marmarou, Petra M Klinge, Marvin Bergsneider, Peter Mcl BlackAbstract:OBJECTIVE: The precise incidence and prevalence of idiopathic Normal-Pressure Hydrocephalus (INPH) is not known, and evidence-based clinical diagnostic criteria have not been developed previously. This report contains evidence-based guidelines for clinical diagnosis of INPH that are intended to facilitate future epidemiological studies of INPH, promote earlier and more accurate diagnosis, and ultimately improve treatment outcome. METHODS: The criteria for the diagnosis of INPH are based on evidence from the medical literature, supplemented as necessary by expert opinion. From 1966 to 2003, 653 publications on "Normal-Pressure Hydrocephalus" were cited in MEDLINE, including 29 articles that met the more stringent criteria of including "idiopathic Normal-Pressure Hydrocephalus" in their title. Additional studies were considered that explicitly identified INPH cases and/or specified the criteria for a diagnosis of INPH. Studies were graded according to the class of evidence and results summarized in evidentiary tables. For issues of clinical relevance that lacked substantive evidence from the medical literature, the opinions of consulting experts were considered and contributed to "Options." RESULTS: Evidence-based guidelines for the clinical diagnosis of INPH have been developed. A detailed understanding of the range of clinical manifestations of this disorder and adherence to practice guidelines should improve the timely and accurate recognition of this disorder. CONCLUSION: It is recommended that INPH be classified into probable, possible, and unlikely categories. We hope that these criteria will be widely applied in clinical practice and will promote greater consistency in patient selection in future clinical investigations involving INPH.
Michael A. Williams - One of the best experts on this subject based on the ideXlab platform.
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Extended lumbar drainage in idiopathic Normal Pressure Hydrocephalus: a systematic review and meta-analysis of diagnostic test accuracy.
British journal of neurosurgery, 2020Co-Authors: Adam Nunn, Michael A. Williams, Cezar Octavian Morosanu, Hayley E Jones, William G. B. Singleton, Sean J. Nagel, Mark G. Luciano, Thomas J. Zwimpfer, Richard Holubkov, Jeffrey H. WisoffAbstract:When appropriately selected, a high proportion of patients with suspected idiopathic Normal Pressure Hydrocephalus (iNPH) will respond to cerebrospinal fluid diversion with a shunt. Extended lumbar...
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Hydrocephalus in the Elderly: Diagnosis of Idiopathic Normal Pressure Hydrocephalus
Brain and Spine Surgery in the Elderly, 2017Co-Authors: Albert M. Isaacs, Mark G. Hamilton, Michael A. WilliamsAbstract:Idiopathic Normal Pressure Hydrocephalus (iNPH) is a neurological disorder of the elderly characterized by gait impairment, urinary urgency or incontinence, and dementia in association with enlargement of the cerebral ventricles secondary to impaired circulation of cerebrospinal fluid (CSF), first described by Salomon Hakim in 1965. The only effective treatment of iNPH is CSF diversion with shunt surgery.
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diagnosis and treatment of idiopathic Normal Pressure Hydrocephalus
Continuum. Lifelong Learning in Neurology, 2016Co-Authors: Michael A. Williams, Jan MalmAbstract:PURPOSE OF REVIEW: This article provides neurologists with a pragmatic approach to the diagnosis and treatment of idiopathic Normal Pressure Hydrocephalus (iNPH), including an overview of: (1) key ...
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diagnosis and management of idiopathic Normal Pressure Hydrocephalus
Neurology. Clinical practice, 2013Co-Authors: Michael A. Williams, Norman RelkinAbstract:The diagnosis and management of idiopathic Normal-Pressure Hydrocephalus (iNPH), a disorder of gait impairment, incontinence, and dementia that affects elderly patients, incorporates an organized approach using familiar principles for neurologists. The starting point is a comprehensive history and neurologic examination, review of neuroimaging, and evaluation of the differential diagnosis. Coexisting disorders should be treated before specific iNPH testing is performed. Specific iNPH testing includes assessing patient response to temporary CSF removal and testing CSF hydrodynamics. In properly selected patients, all iNPH symptoms, including dementia, can improve after shunt surgery. The longitudinal care of iNPH patients with shunts includes evaluation of the differential diagnosis of worsening iNPH symptoms and treatment of coexisting disorders. Evaluation of shunt obstruction is often indicated, and if it is found, surgical correction is likely to result in symptomatic improvement.
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baseline neuropsychological profile and cognitive response to cerebrospinal fluid shunting for idiopathic Normal Pressure Hydrocephalus
Dementia and Geriatric Cognitive Disorders, 2005Co-Authors: George H Thomas, Matthew J Mcgirt, Graeme F Woodworth, Jennifer Heidler, Daniele Rigamonti, Argye E Hillis, Michael A. WilliamsAbstract:Objective: To evaluate neurocognitive changes and predict neurocognitive outcome after ventriculoperitoneal shunting for idiopathic Normal Pressure Hydrocephalus (INPH). Ba
Konstantinos N. Paterakis - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic third ventriculostomy in the treatment of idiopathic Normal Pressure Hydrocephalus: a review study
Neurosurgical Review, 2016Co-Authors: Anastasia Tasiou, Alexandros G. Brotis, Felice Esposito, Konstantinos N. PaterakisAbstract:Idiopathic Normal Pressure Hydrocephalus is a hydrodynamic disorder whose etiology remains unclear. The diagnosis is mainly clinical and the traditional treatment is cerebrospinal fluid shunt diversion. With the introduction of modern management strategies, endoscopic third ventriculostomy has become a viable alternative to shunting and constitutes a well-established method of treatment for obstructive Hydrocephalus. The new hydrodynamic concept of Hydrocephalus suggests that endoscopic third ventriculostomy (ETV) may be an effective treatment for communicative Hydrocephalus. In our current review, the authors focus on the up-to-date knowledge regarding the consideration of endoscopic third ventriculostomy as a safe surgical option in the management of idiopathic Normal Pressure Hydrocephalus.
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Endoscopic third ventriculostomy in the treatment of idiopathic Normal Pressure Hydrocephalus: a review study
Neurosurgical Review, 2016Co-Authors: Anastasia Tasiou, Alexandros G. Brotis, Felice Esposito, Konstantinos N. PaterakisAbstract:Idiopathic Normal Pressure Hydrocephalus is a hydrodynamic disorder whose etiology remains unclear. The diagnosis is mainly clinical and the traditional treatment is cerebrospinal fluid shunt diversion. With the introduction of modern management strategies, endoscopic third ventriculostomy has become a viable alternative to shunting and constitutes a well-established method of treatment for obstructive Hydrocephalus. The new hydrodynamic concept of Hydrocephalus suggests that endoscopic third ventriculostomy (ETV) may be an effective treatment for communicative Hydrocephalus. In our current review, the authors focus on the up-to-date knowledge regarding the consideration of endoscopic third ventriculostomy as a safe surgical option in the management of idiopathic Normal Pressure Hydrocephalus.
