Background: Normal pressure hydrocephalus is a chronic
steadily progressing disease, characterized by an expansion of the
ventricles of the brain with normal (ICP). The aim of this study
was to study the importance of completing the clinical triad in the
diagnosis, clarify the rule of MRI Flowmetry in the decision of
V-P shunt insertion in patients with NPH Methods: This study
has been done on 25 patients who were suspected to have
(iNPH). Patients were divided into two groups; group A included
12 patients with stroke volume above 42 microliter/cycle in MRCSF Fflowmetry and group B included 13 patients with stroke
volume below 42 microliter/cycle. These patients have been
subjected to clinical examination, radiological, and laboratory
investigations. Results: There is a highly statistical significance
between these two items as following; Dementia: All cases
improved after tapping (11 cases), improved after shunting and
12 cases out of 14 did not show improvement in the test and
shunting with a highly significant P value, Gait disturbance: 11
cases improved after tapping in comparison to 10 cases improved
after shunting and 13 cases out of 14 did not show improvement
in the test and shunting with a significant P value. Urinary
incontinence: 11 cases improved after tapping in comparison to
13 cases improved after shunting and 11 cases out of 14 did not
show improvement in the test and shunting with a highly
significant P value. Conclusions: CSF Tapping and clinical FU
after tapping is the most important test in the decision of
shunting. |
