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Diagnosis and treatment of idiopathic normal pressure hydrocephalus.

by Vacca V
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

Article Abstract:

Idiopathic normal pressure hydrocephalus (INPH) is characterized by a classic triad of symptoms including dementia, urinary incontinence, and gait disturbance. INPH is clinically diagnosed in most patients during the sixth or seventh decade of life. Many older adults are incorrectly diagnosed with disorders such as Parkinson's disease and dementia when their symptoms are actually caused by INPH. As life expectancy increases, the necessity of accurately diagnosing and effectively treating these affected individuals will become more challenging. The diagnosis of INPH is challenging and requires a combination of clinical signs and symptoms, radiographic findings, and diagnostic testing. The purpose of evaluation and testing of individuals with suspected INPH is to determine if surgical implantation of a ventriculoperitoneal (VP) shunt will be beneficial. VP shunting is now a common neurosurgical procedure, but it is one associated with risks and complications, which makes evaluation of "shunt-responsiveness" essential.

Bedside diagnosis of hidrocephalus.

By: Sergio Stagnaro - Tue 5/08/2007 PM
I described earlier hydrocephalus clinical symptomatology, detected bedside rapidly and easily by means of a sthetoscope (1) (See www.semeioticabiofisica.it, Practical Applications. These clinical signs are reliable and usefull also in early detecting meningismus as well as meningitis (see above-cited website, URL http://www.semeioticabiofisica.it/semeioticab... %20Diagnosi%20SB%20eng.doc; you may ask to www.Google.com "Stagnaro S Meningitis" I'dd appreciate private comunications of colleagues, who will perform Biophysical Semeiotics, even in other disorder diagnosis (e-mail: dottsergio@semeioticabiofisica.it)



1) Stagnaro S., Auscultatory percussion of the cerebral tumour: Diagnostic importance of the evoked potentials, Biol. Med., 7, 171-175, 1985. 2) Stagnaro S., Auscultatory Percussion Therapeutic Monitoring and Cerebral Dominance in Rheumatology. 2nd World Congress of Inflammation, Antirheumatics, analgesics, immunomodulators. Abstracts, A. Book 1, pg. 116, March 19-22, Montecarlo.

Diagnosis of Idiopathic Normal Pressure Hydrocephalus

By: Stephen Dolle - Mon 5/07/2007 PM
It would seem there should be broader inclusion of the acetazolamide challenge test (ACT) in understanding the degree of favorable response one might anticipate when shunting persons with suspected dx of INPH. As a favorable ACT response requires a favorable degree of baseline CBF, it would seem this could serve as an addiotnal pass/fail test in the ultimate decision on whether to shunt, or not.
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