Normal Pressure Hydrocephalus : Pathophysiology - Diagnosis - Treatment.

Normal Pressure Hydrocephalus: Pathophysiology Diagnosis Treatment -- Title Page -- Copyright -- Contributors -- Preface -- Contents -- 1 Introduction -- 1.1 Why a Book about NPH? -- 2 Epidemiology of Idiopathic Normal Pressure Hydrocephalus -- 2.1 Epidemiologic Studies -- 2.1.1 Trenkwalder et al (1995) -- 2.1.2 Tisell et al (2005) -- 2.1.3 Marmarou et al (2007) -- 2.1.4 Hiraoka et al (2008) -- 2.1.5 Brean and Eide (2008) -- 2.1.6 Brean et al (2009) -- 2.1.7 Tanaka et al (2009) -- 2.1.8 Iseki et al (2009) -- 2.1.9 Klassen and Ahlskog (2011) -- 2.2 Discussion -- 2.3 Summary -- 3 History -- 3.1 Early History -- 3.2 Hydrocephalus and its Treatment in the 19th and 20th Centuries -- 3.3 Development of Modern Shunt Concepts -- 3.4 Hakim and the Discovery of Normal Pressure Hydrocephalus -- 3.5 Modern Shunt Technology and Perspectives -- 4 Clinical Characteristics and Differential Diagnosis -- 4.1 Natural History -- 4.2 Symptoms of iNPH -- 4.2.1 Main Symptoms -- 4.2.2 Other Symptoms -- 4.3 Differential Diagnosis -- 4.3.1 Secondary NPH and Chronic Obstructive Hydrocephalus -- 4.3.2 Parkinson Disease -- 4.3.3 Alzheimer Disease -- 4.3.4 Binswanger Disease (Subcortical Vascular Dementia) -- 4.3.5 Brain Atrophy -- 4.3.6 Cervical Myelopathy -- 4.3.7 Lumbar Spinal Canal Stenosis -- 4.4 Summary -- 5 Pathophysiology -- 5.1 What Causes iNPH? Theories Proposed by the Discoverers and the Bulk Flow Theory -- 5.2 Inner Contradictions -- 6 Noninvasive DiagnosticWork-up -- 6.1 Evaluation of the Patient's Medical History -- 6.2 Clinical Examination -- 6.2.1 Evaluating Gait Disturbance -- 6.2.2 Evaluating Incontinence -- 6.2.3 Neuropsychological Testing -- 6.3 Summary -- 7 Imaging -- 7.1 Computed Tomography -- 7.2 Subjective Assessment of Ventricular Size and Shape -- 7.3 Indices -- 7.3.1 Evans Index -- 7.3.2 Other Indices -- 7.3.3 Third Ventricle Diameter.

7.4 MRI/Phase-Contrast MRI -- 7.5 Diffusion Tensor Imaging -- 7.6 Multifrequency Magnetic Resonance Elastography -- 7.7 Direct Postoperative Imaging -- 7.8 Imaging for Routine Follow-Up -- 7.9 Native Radiography/Valve Setting -- 7.10 Using Imaging for Troubleshooting -- 7.10.1 Overdrainage -- 7.10.2 Underdrainage -- 8 Invasive Diagnostic Work-up -- 8.1 Intracranial Pressure Monitoring -- 8.2 Lumbar Infusion Test -- 8.2.1 Outflow Resistance -- 8.2.2 Calculation Procedure -- 8.2.3 Dynamic Infusion Test Within the Investigation Chain -- 8.3 CSF Tap Test -- 8.4 External Lumbar Drainage -- 8.5 CSF and Serum Biochemical Tests -- 8.6 Diagnostic Pathway -- 9 Shunt and Valve Technology -- 9.1 Definition -- 9.2 Types -- 9.3 Physical Basics -- 9.4 Hydrostatic Pressure -- 9.5 Physics of Ventriculoperitoneal Shunts -- 9.6 Ventriculoatrial Shunts -- 9.7 Classification of Valves -- 9.8 Adjustable Differential Pressure Valves -- 9.9 Hydrostatic Devices -- 9.9.1 Adjustable Hydrostatic Devices -- 10 Shunt and Valve Settings -- 10.1 Shunt Settings -- 10.2 Shunt Settings -- 10.2.1 Ventriculoatrial versus Ventriculoperitoneal Shunt -- 10.2.2 Frontal versus Parietal/Occipital Bore Hole -- 10.2.3 Selection of Valve Opening Pressure -- 10.2.4 Should the Valve and/or the Gravitational Device be Programmable? -- 10.2.5 Shunt Configuration (with or without a Cerebrospinal Fluid Reservoir) -- 10.2.6 Selecting Catheter Material -- 10.2.7 The "Optimal" Shunt Setting -- 10.3 Shunt Settings -- 10.3.1 Why Use Gravitational Valves? -- 10.3.2 Does Valve Opening Pressure of Hydrostatic Valves Have an Influence on the Course of the Disease? -- 10.3.3 Conclusion regarding Clinical Practice -- 10.4 Efficiency of Gravitational Valves -- 10.4.1 Conclusion -- 11 Surgical Technique -- 11.1 Settings in the Operating Room -- 11.2 Positioning -- 11.3 Shaving and Disinfection -- 11.4 Draping.

11.5 Surgical Procedure -- 11.5.1 Ventricular Catheter -- 11.5.2 Valve -- 11.5.3 Peritoneal Catheter -- 11.6 Alternatives to the VP Shunt -- 12 Endoscopic Third Ventriculostomy in Normal Pressure Hydrocephalus -- 12.1 Rationale for ETV in Communicating Hydrocephalus and NPH -- 12.1.1 ETV in Shunt Failure -- 12.2 Technique -- 12.2.1 Preoperative Planning -- 12.2.2 Positioning of the Patient -- 12.2.3 Surgical Technique -- 12.3 Complications -- 12.4 Outcomes -- 12.5 Summary -- 13 Scales and Scores -- 13.1 Black Grading Scale -- 13.2 Index for Postoperative Improvement -- 13.3 Stein-Langfitt Scale -- 13.4 Kiefer Grading Scale -- 13.5 NPH Recovery Rate -- 13.5.1 Conclusion -- 13.6 Comorbidity Index -- 14 Follow-up Management of Idiopathic Normal Pressure Hydrocephalus -- 14.1 Organizing Follow-up Examinations -- 14.2 Follow-up Intervals -- 14.2.1 One/Three Months -- 14.2.2 Six Months -- 14.2.3 Twelve Months -- 14.3 Should Follow-ups End? -- 15 Complications -- 15.1 Intraoperative Complications -- 15.2 Infections -- 15.2.1 What is a Shunt Infection? -- 15.2.2 Shunt Colonization -- 15.2.3 Shunt-Related CSF Infection/Meningitis -- 15.2.4 Shunt-Related Peritonitis/Abdominal Abscess -- 15.2.5 Epidemiology of Shunt Infections in Patients With iNPH -- 15.2.6 Does My Patient Have a Shunt Infection? -- 15.2.7 How Can Shunt Infections Be Avoided in iNPH? -- 15.2.8 How Can Shunt-Related Infections Be Treated? -- 15.3 Postoperative Complications -- 15.3.1 Underdrainage -- 15.3.2 Overdrainage -- 15.4 Shunt Malfunction: Shunt Revisions -- 15.4.1 When to Revise a Shunt? -- 15.4.2 How to Revise a Shunt? -- 16 Prognosis -- 16.1 Predictors -- 16.2 Improvement of Prognosis -- 17 Summary and Future Perspectives -- 17.1 Educating Medical Personnel -- 17.2 Educating the Public -- 17.3 Role of Biomarkers -- 17.4 Diagnostic Tools and Prediction of Shunt Responsiveness.

17.5 Shunt Technology Improvement -- Index.

Often misunderstood and misdiagnosed, normal pressure hydrocephalus (NPH) is a disease of the elderly that is on the rise as the population ages. Its similarities to Parkinson's disease, dementia and other chronic neurodegenerative conditions make diagnosis challenging, requiring clinicians to be alert to the signs and symptoms that differentiate it. Here is the first comprehensive book on the topic, written by experts who have researched and taught courses on NPH for years. From clinical characteristics and pathophysiology to signs and symptoms, radiographic findings, diagnostic tests and state-of-the-art treatment techniques, it covers everything practitioners need to know about this multi-faceted condition. Special Features: Describes the classic symptom triad of gait disturbance, urinary incontinence and dementia Covers the full sequence of the diagnostic work-up, including imaging studies, non-invasive tests, and invasive procedures such as lumbar infusion and cerebrospinal tap tests Explains the risks and benefits of surgical implantation of a ventricular-peritoneal (VP) shunt to relieve symptoms and restore function, including key criteria for evaluating "shunt responsiveness" Provides the first step-by-step account of operative shunt placement by Dr. Michael Fritsch, who has performed the procedure extensively at leading neurosurgical centers throughout the world Including troubleshooting techniques following shunt surgery, long-term management of patients, prognosis for the condition and future initiatives, this all-inclusive reference makes a major contribution to the field. It is essential for neurosurgeons, neurologists, internists, residents, and other physicians who treat diseases of the elderly in everyday practice.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.