Klinische Symptomatik und Diagnostik des idiopathischen Normaldruckhydrozephalus

U. Meier; J. Lemcke

doi:10.1055/s-0038-1628241

Nervenheilkunde, Table of Contents

Nervenheilkunde 2012; 31(07/08): 543-548
DOI: 10.1055/s-0038-1628241

Kinder- und Jugendpsychiatrie

Schattauer GmbH

Klinische Symptomatik und Diagnostik des idiopathischen Normaldruckhydrozephalus

Clinical symptoms and diagnostics of the idiopathic normal pressure hydrocephalus

Authors

U. Meier

¹Klinik für Neurochirurgie, Unfallkrankenhaus Berlin
J. Lemcke

¹Klinik für Neurochirurgie, Unfallkrankenhaus Berlin

Abstract

Zusammenfassung

Der idiopathische Normaldruckhydrozephalus ist eine Differenzialdiagnos bei Patienten jenseits des 50. Lebensjahres, die sich mit einem kleinschrittigen, breitbasigen Gangbild vorstellen und in der zerebraler Computertomografie eine Erweiterung der inneren Liquorräume zeigen. Zur erschöpfenden Diagnostik sollten diese Patienten spätestens sechs bis zwölf Monate nach Einsetzen der Symptome in einer spezialisierten Klinik vorgestellt werden.

Summary

Idiopathic normal pressure hydrocephalus is a differential diagnosis in patients older than 50 years presenting with gait ataxia and enlargement of the lateral ventricles. Those patients should be transferred to a specialised neurosurgical department for diagnostics within six to twelve months after onset of symptoms.

Schlüsselwörter

Idiopathischer Normaldruckhydrozephalus - Hakim-Trias - Gangataxie - invasive Diagnostik

Keywords

Idiopathic normal pressure hydrocephalus - Hakim triad - gait ataxia - invasive diagnostics

Full Text

References

Literatur
1 Adams RD. et al. Symptomatic occult hydrocephalius with normal“ cerebral-fluid pressure. A treatable symptome. N Engl J Med 1965; 273: 117-26.
2 Hakim CA. et al. Normal-pressure hydrocephalus. Neurosurg Clin N Am 2001; 12 (04) 761-73.
3 Black PM. Normal-pressure hydrocephalus: current understanding of diagnostic tests and shunting. Postgrad Med 1982; 71 (02) 57.
4 Borgesen SE. Conductance to outflow of CSF in normal pressure hydrocephalus. Acta Neurochir (Wien) 1984; 71 1–2 1-45.
5 Gjerris F, Borgesen SE. Current concepts of measurement of cerebrospinal fluid absorption and biomechanics of hydrocephalus. Adv Tech Stand Neurosurg 1992; 19: 145-77.
6 Brean A. et al. Five-year incidence of surgery for idiopathic normal pressure hydrocephalus in Norway. Acta Neurol Scand 2009; 120 (05) 314-6.
7 Dauch WA, Zimmermann R. [Normal pressure hydrocephalus. An evaluation 25 years following the initial description]. Fortschr Neurol Psychiatr 1990; 58 (05) 178-90.
8 Esmonde T, Cooke S. Shunting for normal pressure hydrocephalus (NPH). Cochrane Database Syst Rev 2002; (3): CD003157.
9 Dandy WE. Expiration of the choroid plexus of the lateral ventricles in communicating hydrocephalus. Ann Surg 1918; 68 (06) 569-79.
10 Lemcke J. et al. Is it possible to minimize overdrainage complications with gravitational units in patients with idiopathic normal pressure hydrocephalus? Protocol of the randomized controlled SVASONA Trial (ISRCTN51046698). Acta Neurochir Suppl 2010; 106: 113-5.
11 Black PM, Ojemann RG, Tzouras A. CSF shunts for dementia, incontinence, and gait disturbance. Clin Neurosurg 1985; 32: 632-51.
12 Black PM. Idiopathic normal-pressure hydrocephalus. Results of shunting in 62 patients. J Neurosurg 1980; 52 (03) 371-7.
13 Clarfield AM. Normal-pressure hydrocephalus: saga or swamp?. JAMA 1989; 262 (18) 2592-3.
14 Meier U, Zeilinger FS, Kintzel D. [Psychophysiology, signs and symptoms of disease the course of normal pressure hydrocephalus]. Fortschr Neurol Psychiatr 1998; 66 (04) 176-91.
15 Greenberg JO. et al. Idiopathic normal pressure hydrocephalus – a report of 73 patients. J Neurol Neurosurg Psychiatry 1977; 40 (04) 336-41.
16 Spanu G, Sangiovanni G, Locatelli D. Normal-pressure hydrocephalus: twelve years experience. Neurochirurgia (Stuttg) 1986; 29 (01) 15-9.
17 Ojemann RG. et al. Further experience with the syndrome of normal“ pressure hydrocephalus. J Neurosurg 1969; 31 (03) 279-94.
18 Fisher CM. The clinical picture in occult hydrocephalus. Clin Neurosurg 1977; 24: 270-84.
19 Bowen M. et al. Pseudopsychopathic syndrome in hydrocephalus: a case report and review. Neurosurgery 1990; 26 (04) 661-3.
20 Rice E, Gendelman S. Psychiatric aspects of normal pressure hydrocephalus. JAMA 1973; 223 (04) 409-12.
21 Fisher CM. Hydrocephalus as a cause of disturbances of gait in the elderly. Neurology 1982; 32 (12) 1358-63.
22 Gustafson L, Hagberg B. Recovery in hydrocephalic dementia after shunt operation. J Neurol Neurosurg Psychiatry 1978; 41 (10) 940-7.
23 Adams RD. Recent observations on normal pressure hydrocephalus. Schweiz Arch Neurol Neurochir Psychiatr 1975; 116 (01) 7-15.
24 Jansen J, Jorgensen M. Prognostic significance of signs and symptoms in hydrocephalus. Analysis of survival. Acta Neurol Scand 1986; 73 (01) 55-65.
25 Sudarsky L, Simon S. Gait disorder in late-life hydrocephalus. Arch Neurol 1987; 44 (03) 263-7.
26 Soelberg SP. et al. Motor disturbances in normal-pressure hydrocephalus. Special reference to stance and gait. Arch Neurol 1986; 43 (01) 34-8.
27 Sypert GW. et al. . Occult normal pressure hydro-cephalus manifested by parkinsonism-dementia complex. Neurology 1973; 23 (03) 234-8.
28 Meier U, Zeilinger FS, Kintzel D. Signs, symptoms and course of normal pressure hydrocephalus in comparison with cerebral atrophy. Acta Neurochir (Wien) 1999; 141 (10) 1039-48.
29 Meier U. et al. [Indications for the intrathecal infusion test in disorders of cerebrospinal fluid dynamics]. Zentralbl Neurochir 1990; 51 (02) 107-11.
30 Nichtweiss M, Heetderks G, Rosenthal D. [Diagnosis of idiopathic so-called normal pressure hydrocephalus. Data from clinical findings, computerized tomography and epidural pressure measurement]. Nervenarzt 1988; 59 (05) 267-73.
31 Cardoso ER, Del Bigio MR, Schroeder G. Age-dependent changes of cerebral ventricular size. Part I: Review of intracranial fluid collections. Acta Neurochir (Wien) 1989; 97 1–2 40-6.
32 Cardoso ER, Del Bigio MR. Age-related changes of cerebral ventricular size. Part II: Normalization of ventricular size following shunting. Acta Neurochir (Wien) 1989; 97 3–4 135-8.
33 Meier U. et al. Is decreased ventricular volume a correlate of positive clinical outcome following shunt placement in cases of normal pressure hydrocephalus?. Acta Neurochir Suppl 2003; 86: 533-7.
34 Casmiro M. et al. Risk factors for the syndrome of ventricular enlargement with gait apraxia (idiopathic normal pressure hydrocephalus): a case-control study. J Neurol Neurosurg Psychiatry 1989; 52 (07) 847-52.
35 Borgesen S. et al. Cerebrospinal fluid conductance and compliance of the craniospinal space in normal-pressure hydrocephalus. A comparison between two methods for measuring conductance to outflow. J Neurosurg 1979; 51 (04) 521-5.
36 Tans JT, Poortvliet DC. Comparison of ventricular steady-state infusion with bolus infusion and pressure recording for differentiating between arrested and non-arrested hydrocephalus. Acta Neurochir (Wien) 1984; 72 1–2 15-29.
37 Bannister R. et al. Isotope encephalography in the diagnosis of dementia due to communicating hydrocephalus. Lancet 1967; 2 7524 1014-7.
38 Borgesen SE. et al. Computed tomography and pneumoencephalography compared to conductance to outflow of CSF in normal pressure hydro-cephalus. Neuroradiology 1980; 20 (01) 17-22.
39 Albeck MJ. et al. Intracranial pressure and cerebrospinal fluid outflow conductance in healthy subjects. J Neurosurg 1991; 74 (04) 597-600.
40 Marmarou A. et al. Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system. J Neurosurg 1975; 43 (05) 523-34.
41 Katzman R, Hussey F. A simple constant-infusion manometric test for measurement of CSF absorption. I. Rationale and method. Neurology 1970; 20 (06) 534-44.
42 Hussey F. et al. A simple constant-infusion manometric test for measurement of CSF absorption. II. Clinical studies. Neurology 1970; 20 (07) 665-80.
43 Meier U, Bartels P. The importance of the intrathecal infusion test in the diagnosis of normal pressure hydrocephalus. J Clin Neurosci 2002; 9 (03) 260-7.
44 Hebb AO, Cusimano MD. Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. Neurosurgery 2001; 49 (05) 1166-84.
45 Kahlon B, Sundbarg G, Rehncrona S. Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 2002; 73 (06) 721-6.
46 Ishikawa M. Clinical guidelines for idiopathic normal pressure hydrocephalus. Neurol Med Chir (Tokyo) 2004; 44 (04) 222-3.
47 Marmarou A, Black P, Bergsneider M, Klinge P, Relkin N. Guidelines for management of idiopathic normal pressure hydrocephalus: progress to date. Acta Neurochir Suppl 2005; 95: 237-40.
48 Malm J. et al. Cerebrospinal fluid shunt dynamics in patients with idiopathic adult hydrocephalus syndrome. J Neurol Neurosurg Psychiatry 1995; 58 (06) 715-23.
49 Wikkelso C, Andersson H, Blomstrand C, Lindqvist G, Svendsen P. Normal pressure hydrocephalus. Predictive value of the cerebrospinal fluid tap-test. Acta Neurol Scand 1986; 73 (06) 566-73.
50 Ishikawa M. et al. Guidelines for management of idiopathic normal pressure hydrocephalus. Neurol Med Chir (Tokyo) 2008; 48 Suppl: S1-23.
51 Sand T. et al. Idiopathic normal pressure hydrocephalus: the CSF tap-test may predict the clinical response to shunting. Acta Neurol Scand 1994; 89 (05) 311-6.
52 Ravdin LD. et al. Features of gait most resp. Clin Neurol Neurosurg 2008; 110 (05) 455-61.
53 Haan J, Thomeer RT. Predictive value of temporary external lumbar drainage in normal pressure hydrocephalus. Neurosurgery 1988; 22 (02) 388-91.
54 Panagiotopoulos V. et al. The predictive value of external continuous lumbar drainage, with cerebrospinal fluid outflow controlled by medium pressure valve, in normal pressure hydrocephalus. Acta Neurochir (Wien) 2005; 147 (09) 953-8.
55 Sharma AK. et al. Measurement of peak CSF flow velocity at cerebral aqueduct, before and after lumbar CSF drainage, by use of phase-contrast MRI: utility in the management of idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg 2008; 110 (04) 363-8.
56 Komotar RJ. et al. Cervical spine disease may result in a negative lumbar spinal drainage trial in normal pressure hydrocephalus: case report. Neurosurgery 2008; 63 4 Suppl 2 315.
57 Governale LS. et al. Techniques and complications of external lumbar drainage for normal pressure hydrocephalus. Neurosurgery 2008; 63 4 Suppl 2 379-84.
58 Meier U, Lemcke J, Al-Zain F. Course of disease in patients with idiopathic normal pressure hydrocephalus (iNPH): a follow-up study 3, 4 and 5 years following shunt implantation. Acta Neurochir Suppl 2008; 102: 125-7.
59 Al-Zain FT. et al. The role of cerebrospinal fluid flow study using phase contrast MR imaging in Diagnosing idiopathic normal pressure hydrocephalus. Acta Neurochir Suppl 2008; 102: 119-23.
60 Meier U, Kiefer M, Sprung C. Normal pressure hydrocephalus: pathology, pathophysiology, diagnostics, therapeutics and clinical course. Erwitte: PVV Science Publications; 2003
61 Gaab MR. et al. Pressure-volume diagram, pulse amplitude and intracranial pulse volume. Analysis and significance. In: Intracranial Pressure V. Ishii S. et al. (eds.). Berlin: Springer; 1983: 261-8.
62 Kosteljanetz M. Intracranial pressure: cerebrospinal fluid dynamics and pressure-volume relations. Acta Neurol Scand 1987; 75: 7-23.
63 Brean A, Eide PK. Assessment of idiopathic normal pressure patients in neurological practice: the role of lumbar infusion testing for referralofpatients to neurosurgery. Eur J Neurology 2008; 15: 605-12.
64 Eide PK, Brean A. Cerbrospinal fluid pulse pressure amplitude during lumbar infusion in idiopathic normal pressure hydrocephalus can predict response to shunting. Cerebrospinal Fluid Research 2010; 7: 5.
65 Pfisterer WK. et al. Continuous intraventricular pressure monitoring for diagnosis of normal-pressure hydrocephalus. Acta Neurochir 2007; 149: 983-90.
66 Frank AM. et al. Non-invasive measurement of intracranialpressure by otoacoustic emissions (OAEs) – a report of preliminary data. Zentralbl Neurochir 2000; 61: 177-80.