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Johannsson B, Munthe S, Poulsen FR, et al. Idiopathic normal pressure hydrocephalus; treatment and outcome in the Region of Southern Denmark. Clin Neurol Neurosurg. 2021;213:107107doi: 10.1016/j.clineuro.2021.107107.
Johannsson, B., Munthe, S., Poulsen, F. R., & Pedersen, C. B. (2021). Idiopathic normal pressure hydrocephalus; treatment and outcome in the Region of Southern Denmark. Clinical neurology and neurosurgery, 213107107. https://doi.org/10.1016/j.clineuro.2021.107107
Johannsson, Bjarni, et al. "Idiopathic normal pressure hydrocephalus; treatment and outcome in the Region of Southern Denmark." Clinical neurology and neurosurgery vol. 213 (2021): 107107. doi: https://doi.org/10.1016/j.clineuro.2021.107107
Johannsson B, Munthe S, Poulsen FR, Pedersen CB. Idiopathic normal pressure hydrocephalus; treatment and outcome in the Region of Southern Denmark. Clin Neurol Neurosurg. 2021 Dec 29;213:107107. doi: 10.1016/j.clineuro.2021.107107. Epub 2021 Dec 29. PMID: 34974379.
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Clin Neurol Neurosurg. 2021 Dec 29;213:107107. doi: 10.1016/j.clineuro.2021.107107. Epub 2021 Dec 29.

Idiopathic normal pressure hydrocephalus; treatment and outcome in the Region of Southern Denmark.

Clinical neurology and neurosurgery

Bjarni Johannsson, Sune Munthe, Frantz Rom Poulsen, Christian Bonde Pedersen

Affiliations

  1. OPEN - Open Patient data Explorative Network, J. B. Winsløws Vej 9a, Odense, Denmark; Department of Clinical Research, University of Southern Denmark and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), Odense, Denmark; Department of Neurosurgery, Odense University Hospital, J. B. Winsløws Vej 9a, Odense, Denmark. Electronic address: [email protected].
  2. OPEN - Open Patient data Explorative Network, J. B. Winsløws Vej 9a, Odense, Denmark; Department of Clinical Research, University of Southern Denmark and BRIDGE (Brain Research-Interdisciplinary Guided Excellence), Odense, Denmark; Department of Neurosurgery, Odense University Hospital, J. B. Winsløws Vej 9a, Odense, Denmark.

PMID: 34974379 DOI: 10.1016/j.clineuro.2021.107107

Abstract

OBJECTIVE: Idiopathic normal pressure hydrocephalus (iNPH) is a prevalent and cost-effective disease to treat. However, no gold standard exists to confidently select patients for shunt surgery. The aim of this study was to investigate how patients with suspected iNPH at our center responded to shunt surgery and to compare pre-surgical variables between shunt responders and non-responders.

METHODS: Preoperative baseline characteristics, MRI and/or CT scans were retrospectively obtained in 55 shunt-operated iNPH patients. Evan's index, third ventricle diameter, dilation of Sylvian fissures, tight high convexity, focal sulci, callosal angle, Rout value, MMSE score, CSF phosphorylated tau, CSF tau, and a combination of radiologic findings (DESH score) were compared according to whether or not patients expressed satisfactory response to shunt treatment at 1-month follow-up.

RESULTS: Multiple logistic regression controlling for age and gender (α = 0.05) showed that tight high convexity, dilated Sylvian fissures, focal sulci, CSF tau, CSF phosphorylated tau, and DESH score correlated significantly with subjective shunt response at 1-month follow-up.

CONCLUSION: In line with current literature, Shunt responders had lower levels of CSF tau and CSF phosphorylated tau compared to non-responders. While commonly used radiologic markers are of value, they can be aggregated into a score for better selection of shunt candidates.

Copyright © 2021 Elsevier B.V. All rights reserved.

Keywords: CSF biomarkers; Dementia and related disorders; Neurodegenerative disorders; Neurogeriatrics; Neuroimaging

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