Cognitive, biochemical, and imaging profile of patients suffering from idiopathic normal pressure hydrocephalus
Abstract Introduction It has still not been clearly established whether the cognitive deficits of idiopathic normal pressure hydrocephalus (iNPH) are caused by a disturbance in cerebrospinal fluid (CSF) dynamics or an underlying metabolic disturbance. Objective To identify the possible associations between biochemical markers, the neuroimaging characteristics, and cognitive deficits of patients undergoing investigations for possible iNPH. Methods A CSF sample obtained during a lumbar puncture from 10 patients with iNPH was analyzed for several biochemical markers (lactate, 8-isoprostane, vascular endothelial growth factor [VEGF], neurofilament heavy protein, glial fibrillary acidic protein,…
Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus
To the Editor:We read with interest the article by McGirt et al. (9) entitled“Diagnosis, Treatment, and Analysis of Long-term Outcomes inIdiopathic Normal Pressure Hydrocephalus.” The authors con-clude that gait impairment is the primary symptom that inde-pendently predicted improvement after shunting. The studyincluded 132 patients, 129 (98%) of whom had gait impairmentas a feature. We would like to comment on this particular selec-tion criterion, as well as improvements in the Mini Mental StateExamination (MMSE) as the sole measure of postoperative cog-nitive improvement.One of the inclusion criteria for this study was presentationwith two or more features of the classic triad. Thus, the …