OBJECTIVE To characterize the association between arterial blood pressure (ABP) and intracranial pressure (ICP) in idiopathic normal pressure hydrocephalus (iNPH) patients, and its impact on outcome of shunt surgery. MATERIALS AND METHODS We analyzed all 35 iNPH patients whose ABP and ICP were recorded simultaneously during 6 years (2002-2007). The static and pulsatile pressures were averaged...

In an effort to identify critical gaps in the prevailing knowledge of hydrocephalus, the authors formulated 10 key questions. 1) How do we define hydrocephalus? 2) How is cerebrosinal fluid (CSF) absorbed normally and what are the causes of CSF malabsorption in hydrocephalus? 3) Why do the ventricles dilate in communicating hydrocephalus? 4) What happens to the structure and function of the bra...

A 62-year-old man presented with a 2-month history of psychiatric symptoms. These were preceded by cognitive deterioration, urinary incontinence and an abnormal gait. A diagnosis of normal-pressure hydrocephalus (NPH) was made, and the patient improved after surgery.

Although extrapyramidal features in normal pressure hydrocephalus (NPH) are not uncommon, presentations with Parkinson's syndrome as the predominant feature are rare and may give rise to diagnostic difficulties. Failure of patients with parkinsonism to respond to therapy, should alert one to the possibility of NPH.

Background: We have previously seen that idiopathic normal pressure hydrocephalus (iNPH) patients havingelevated intracranial pressure (ICP) pulse amplitude consistently respond to shunt surgery. In this study weexplored how the cerebrospinal fluid pressure (CSFP) pulse amplitude determined during lumbar infusion testing,correlates with ICP pulse amplitude determined during over-nig...

Normal pressure hydrocephalus (NPH) has posed a challenge to neurologists for 5 decades. Difficulties in understanding its pathophysiology have hindered efforts to diagnose it and to develop a better approach to selecting patients for shunt surgery. We know that many patients with NPH have CSF absorption difficulty as measured by resistance to CSF outflow (Rout). The problem is that many with n...

The objective of this prospective study was to find outcome predictors for better selection for treatment of normal-pressure hydrocephalus (NPH) patients. A total of 125 patients were evaluated and provided with a gravitational shunt. Cerebrospinal fluid hydrodynamics provided better predictive values if an algorithm to shunt all patients with a pressure/volume index of < 30 mL or resistance to...

A 67-year-old man took labetalol (Trandate) 400 mg thrice daily and clonidine 0 3 mg daily from June 1977 for hypertension. Methyldopa had been withdrawn because of diarrhoea, and propranolol and clonidine had proved ineffective. Twelve weeks after beginning labetalol he developed an itchy eruption on his penis, which spread to the trunk and limbs. When he attended hospital 10 weeks later the e...

was pain free and walking well on a pylon before receiving a definite prosthesis. Examination of the amputation specimen (Fig. 1) showed an illdefined red tumour lying deep to the Achilles tendon, tumour nodules mingling with adjacent adipose tissue. A number of separate tumour masses were also present in both superficial and deep fascia, the most proximal being attached to the tibia 12 cm abov...

BACKGROUND/AIMS Frontal lobe dysfunction is believed to be a primary cognitive symptom in idiopathic normal pressure hydrocephalus (iNPH); however, the neuropsychology of this disorder remains to be fully investigated. The objective of this study was to delineate a comprehensive profile of cognitive dysfunction in iNPH and evaluate the effects of cerebrospinal fluid (CSF) shunt surgery on cogni...