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Long-term outcome in patients with suspected normal pressure hydrocephalus

Kahlon, Babar LU ; Sjunnesson, Johan and Rehncrona, Stig LU (2007) In Neurosurgery 60(2). p.327-332
Abstract
OBJECTIVE: To evaluate the outcome of patients with suspected normal pressure hydrocephalus at 6 months and 5 years after shunt Surgery. METHODS: Seventy-five patients (mean age, 72.5 +/- 9 yr), with normal pressure hydrocephalus symptoms were included. Fifty-four patients with positive lumbar infusion and/or cerebrospinal fluid tap tests received a cerebrospinal fluid shunt, whereas 21 patients with negative test results did not undergo operation. Walk, reaction time, memory, and identical forms tests were used as baseline (before surgery) tests and were repeated at short- (6.1 +/- 4.6 mo) and long-term (5.5 +/- 1.4 yr) follow-up evaluations. Activities of daily life functions were assessed using the Barthel index. RESULTS: At the 6-month... (More)
OBJECTIVE: To evaluate the outcome of patients with suspected normal pressure hydrocephalus at 6 months and 5 years after shunt Surgery. METHODS: Seventy-five patients (mean age, 72.5 +/- 9 yr), with normal pressure hydrocephalus symptoms were included. Fifty-four patients with positive lumbar infusion and/or cerebrospinal fluid tap tests received a cerebrospinal fluid shunt, whereas 21 patients with negative test results did not undergo operation. Walk, reaction time, memory, and identical forms tests were used as baseline (before surgery) tests and were repeated at short- (6.1 +/- 4.6 mo) and long-term (5.5 +/- 1.4 yr) follow-up evaluations. Activities of daily life functions were assessed using the Barthel index. RESULTS: At the 6-month follow-up examination, 83% of the operated patients improved in gait, 65% improved in reaction time, 46% improved in memory, and 31% improved in identical forms tests; 96% found themselves subjectively improved. Because of unrelated mortality (37%) and declining general health from comorbidity, only 27 patients were available for the 5-year follow-up evaluation. Twenty-three of these patients had been treated with a shunt and had a remaining improvement in close to 40% in gait and reaction time, whereas fewer than 10% had an improvement in cognitive tests. Fifty-six percent reported subjective improvement compared with preoperative findings. More patients (64%) improved if younger than 75 years; for patients older than 75 years, only 11% of the patients improved. The Barthel index was higher (P < 0.05) in improved patients. CONCLUSION: Patients with normal pressure hydrocephalus benefit from shunt surgery for at least 5 years. High mortality rate, comorbidity, and old age hamper good long-term outcome and emphasize the importance of patient selection. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
normal pressure hydrocephalus, idiopathic normal pressure hydrocephalus, outcome, shunt surgery, comorbidity, long-term
in
Neurosurgery
volume
60
issue
2
pages
327 - 332
publisher
Congress of Neurological Surgeons
external identifiers
  • wos:000244154200030
ISSN
0148-396X
DOI
10.1227/01.NEU.0000249273.41569.6E
language
English
LU publication?
yes
id
6c0fb98c-2cd8-4ec4-9f82-226697b066c2 (old id 674489)
alternative location
http://www.neurosurgery-online.com/pt/re/neurosurg/abstract.00006123-200702000-00013.htm
date added to LUP
2007-12-13 14:54:48
date last changed
2016-04-16 03:17:13
@article{6c0fb98c-2cd8-4ec4-9f82-226697b066c2,
  abstract     = {OBJECTIVE: To evaluate the outcome of patients with suspected normal pressure hydrocephalus at 6 months and 5 years after shunt Surgery. METHODS: Seventy-five patients (mean age, 72.5 +/- 9 yr), with normal pressure hydrocephalus symptoms were included. Fifty-four patients with positive lumbar infusion and/or cerebrospinal fluid tap tests received a cerebrospinal fluid shunt, whereas 21 patients with negative test results did not undergo operation. Walk, reaction time, memory, and identical forms tests were used as baseline (before surgery) tests and were repeated at short- (6.1 +/- 4.6 mo) and long-term (5.5 +/- 1.4 yr) follow-up evaluations. Activities of daily life functions were assessed using the Barthel index. RESULTS: At the 6-month follow-up examination, 83% of the operated patients improved in gait, 65% improved in reaction time, 46% improved in memory, and 31% improved in identical forms tests; 96% found themselves subjectively improved. Because of unrelated mortality (37%) and declining general health from comorbidity, only 27 patients were available for the 5-year follow-up evaluation. Twenty-three of these patients had been treated with a shunt and had a remaining improvement in close to 40% in gait and reaction time, whereas fewer than 10% had an improvement in cognitive tests. Fifty-six percent reported subjective improvement compared with preoperative findings. More patients (64%) improved if younger than 75 years; for patients older than 75 years, only 11% of the patients improved. The Barthel index was higher (P &lt; 0.05) in improved patients. CONCLUSION: Patients with normal pressure hydrocephalus benefit from shunt surgery for at least 5 years. High mortality rate, comorbidity, and old age hamper good long-term outcome and emphasize the importance of patient selection.},
  author       = {Kahlon, Babar and Sjunnesson, Johan and Rehncrona, Stig},
  issn         = {0148-396X},
  keyword      = {normal pressure hydrocephalus,idiopathic normal pressure hydrocephalus,outcome,shunt surgery,comorbidity,long-term},
  language     = {eng},
  number       = {2},
  pages        = {327--332},
  publisher    = {Congress of Neurological Surgeons},
  series       = {Neurosurgery},
  title        = {Long-term outcome in patients with suspected normal pressure hydrocephalus},
  url          = {http://dx.doi.org/10.1227/01.NEU.0000249273.41569.6E},
  volume       = {60},
  year         = {2007},
}