OBJECTIVES: To examine the outcome of surgery for idiopathic @entity5083 (iNPH) and how outcome relates to the preoperative static and pulsatile @entity428 ( @entity428 ). METHODS: An observational cohort study included all @entity1 with iNPH managed at our department during the years 2002-2012 in whom overnight @entity428 monitoring was part of the preoperative work-up. Clinical data were retrieved from a quality registry and @entity428 scores from a pressure database. RESULTS: The study included 472 @entity1 , 316 in the surgery group and 156 in the nonsurgery group. Among those treated surgically, 278 (90%) showed clinical improvement (Responders) whereas 32 (10%) had no improvement (Nonresponders). Among Responders, only about one third reached the best clinical scores; moreover, the difference in clinical score between Responders and Nonresponders declined with time after surgery, particularly after 3-4 years. The surgery was accompanied by acute intracranial @entity1410 in 11 @entity1 (3.5%), of whom 4 (1.3%) died. Survival (age at death) was significantly greater among the Responders than in Nonresponders. Although the static @entity428 was normal in all @entity1 , the @entity428 was significantly greater in Responders than in Non-responders. CONCLUSIONS: The @entity428 was greater in shunt Responders than Nonresponders. Although the clinical improvement declined over time and the majority did not experience complete relief of symptoms, shunt Responders lived significantly longer than Nonresponders. The present observations suggest that the current surgical treatment regimens for iNPH (primarily shunt surgery) address only some aspects of the disease process, in particular the aspect of brain water disturbance.

Outcome of Surgery for XXXX : Role of Preoperative Static and Pulsatile Intracranial Pressure.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5083 :: ('MESH:D006850', 'Disease') :: ['normal-pressure hydrocephalus'] @entity1410 :: ('MESH:D006406', 'Disease') :: ['hematomas'] @entity428 :: ('MESH:D019586', 'Disease') :: ['ICP', 'intracranial pressure', 'pulsatile ICP']
@entity5083 :: (MESH:D006850,Disease) :: ['Idiopathic Normal Pressure Hydrocephalus']
