The benefit of delayed reassessment post high-volume CSF removal in the diagnosis of shunt-responsive idiopathic normal-pressure hydrocephalus

Chrisovalantis Tsimiklis, Annika Mascarenhas, Minh Son To, Christine Fairley Bishop, Felicity Jenkinson, Gemma Hunt, Natalie Knight, Marguerite Harding, Santosh Poonnoose

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

The principle aim of the study was to demonstrate the value of performing delayed reassessment in the diagnosis of idiopathic normal-pressure hydrocephalus (iNPH) and selection of suitable candidates for ventriculoperitoneal shunting (VPS). Thirty-one consecutive patients underwent the NPH protocol at the Flinders Medical Centre between March 2017 and November 2018. The protocol involved mobility and cognitive testing with reassessment post high-volume cerebrospinal fluid (CSF) removal at 24 h and 48 h. The Assessment of Quality of Life 6D (AQoL-6D) questionnaire and International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) were completed and repeated again at 6 weeks and 6 months post shunting. Results were analysed to determine the significance of delayed reassessment. Twenty patients (64.5%) underwent insertion of a VPS on the basis of objective improvements and specific criteria. Of these, 6 patients (30%) were shunted based on delayed reassessment at 48 h post CSF removal. Continued improvements were seen for all mobility and cognitive tests from baseline to 48 h post CSF removal. At 6 weeks and 6 months post shunting, there was an overall mean improvement in AQoL-6D and ICIQ-UI SF for the cohort and the improvement was also observed in the subgroup of patients who met shunt criteria at 48 h post CSF removal. In the diagnosis of shunt-responsive idiopathic normal-pressure hydrocephalus, delayed reassessment post CSF removal improves sensitivity and is therefore important.

Original languageEnglish
Pages (from-to)32-38
Number of pages7
JournalJournal of Clinical Neuroscience
Volume71
DOIs
Publication statusPublished - Jan 2020
Externally publishedYes

Keywords

  • Diagnosis
  • Idiopathic
  • Normal-pressure hydrocephalus
  • Ventriculoperitoneal shunt

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