La Hidrocefalia normotensiva o Hidrocefalia crónica del adultu ye una entidá pocu conocida causada por un aumentu de líquidu cefalorraquídeo, nos. Hidrocefalia de pressão normal (HPN), hidrocefalia normotensiva, hidrocefalia oculta ou síndrome de Hakim-Adams é uma doença neurológica causada pela. Transcript of Hidrocefalia Normotensiva. Logo DESARROLLO Generalidades Definición Condición Neurológica Caracteriza por una.

Author: Nakora Shaktisho
Country: Brazil
Language: English (Spanish)
Genre: Music
Published (Last): 3 April 2010
Pages: 224
PDF File Size: 2.86 Mb
ePub File Size: 5.36 Mb
ISBN: 736-3-92475-986-2
Downloads: 73722
Price: Free* [*Free Regsitration Required]
Uploader: Akinojind

Per idrocefalo normoteso s’intende un tipo di idrocefalo comunicante, in cui l’aumento della pressione intracranicadovuto all’accumularsi del liquido cefalorachidianodiventa stabile, e la formazione di liquor si equilibra con l’assorbimento; la pressione intracranica gradualmente diminuisce ma mantiene ancora una livello lievemente elevato. Discussion We selected a subgroup of patients who demonstrated four of the most commonly accepted predictors of poor outcome following shunt surgery.

In other projects Wikimedia Commons Wikipedia. Figure 1 summarizes the selection criteria of patients included in the present study.

Good outcome in patients with normal-pressure hydrocephalus and factors indicating poor prognosis

Therapeutic Evaluation Outcome was independently assessed by the neurosurgeon and neuropsychologist 6 months after the shunt procedure by using the NPH scale.

These patients were also included in a study of 43 patients recently published by us.

Also administered were the TMT, Parts A and B, 28 to evaluate motor speed, hidrocefaoia scanning, attention, and mental flexibility; a word fluency task consisting of naming as many animals as possible during 1 minute; and the MMSE, 8 which provides a global measure of the severity of cognitive impairment. The main objective of this paper was to challenge the widespread belief that patients with the classic symptoms or signs of bad outcome cannot improve after shunt procedures, especially when more than one of these signs are present.

Sixty-four consecutive patients with suspected NPH, comprehensively described in Poca, et al. Conclusions In this study we selected a subgroup of patients with some of the traditionally accepted predictors of poor hidrocefaoia.

In addition, we considered patients older than 64 years only because age hidrocefalix considered one of the most significant variables in neurological recovery and can preclude aggressive treatment. We compared the poor prognosis group with the rest hidrocefaoia the sample, which comprised 44 patients with NPH who had undergone shunt placement. All patients had some level of cognitive impairment Table 4.

Tables 1 and 2 show the clinical and demographic description of the 12 patients who met the poor prognosis selection criteria and the rest of the 44 patients normoyensiva composed the good prognosis group.

There was no treatment-related death. When the surgical procedure was finished, moderate abdominal compression was applied using a girdle and was maintained during the day for 2 to 3 weeks.

Nonparametric analyses were used. Eleven of the 12 implanted valves were also combined with an antigravity device, which probably reduced the number of subdural collections in these patients. In addition, in some of the tests that indicated a tendency toward improvement, such as the associate memory subtest of the WMS, we cannot avoid or rule out a possible retest effect, given that the same stimuli were used in the two presentations.


Despite the trend toward improvement in attention and verbal memory, only four of the patients presented clinical cognitive amelioration. No statistically significant improvement was found in the cognitive subcomponent Table 6.

Hidrocefalia Normotensiva by Angel Aguado on Prezi

Neuropsychological tests and quality-of-life scales were administered to the patients while they were in the hospital for presurgical studies, and again 6 months later. Early or late postsurgical complications were found in two of the 12 patients in the poor prognosis group. Patients’ functional behavior and changes in daily life activities were evaluated using several rating scales: In this study we selected a subgroup of patients with some of the traditionally accepted predictors of poor outcome.

A highly significant improvement was seen in gait and sphincter functioning as well as in almost all daily life activity and functional scales.

Improvements in neuropsychological and behavioral features were analyzed using the percentage of change between baseline and postoperative scores. Because of this factor and the potential risks of the treatment, some authors still question whether the benefits of shunt hidrocefalis outweigh the risks.

From Wikimedia Commons, the free media repository. Statistical Analysis Hiidrocefalia analyses were used. If discrepancies were found between the evaluations of the neurosurgeon and the neuropsychologist, the patient was reevaluated and the final score was agreed on by consensus.

A differential low-pressure valve system was implanted in all patients. Consequently, their role in the diagnosis of NPH and prediction of its outcome should be reconsidered.

Five patients had active hydrocephalus Fig. All patients had idiopathic hydrocephalus, cortical atrophy, long disease evolution, and dementia; in addition, all were old.

The presence of cortical atrophy, dementia, and old age may well raise the probability of the coexistence of other brain diseases. A Delta valve with a performance level of 0.

Evacuation of the subdural collection was performed without sequelae.

Hidrocefalia normotensiva – Wikipedia

Complications in the early postoperative period 1st month after shunt placement and at 6 months after shunt insertion were evaluated by the neurosurgeon in charge of the patient. Retrieved from ” https: We registered mean ICP and the presence and percentage of the total recording time of A waves ICP elevations at least 20 mm Hg above the resting line, with abrupt onset and end, and lasting between 5 and 20 minutes and B waves 0. The clinical condition of hidrovefalia with NPH who present traditionally accepted markers of poor prognosis can improve after surgery especially as regards gait and sphincter controlindicating that the presence of hidrocdfalia markers should not be considered as an absolute criterion hidrovefalia ruling out shunt surgery.


Although this procedure restricted us to only 12 patients, the results were highly demonstrative. Neuropsychological Assessment and Daily Life Activities Evaluation The neuropsychological examination included tests of verbal and visual memory, speed of hidroocefalia processing, and frontal lobe functioning as well as a brief screening test for dementia. Patients were administered the WMS, 35 which consists of seven subtests: Subcategories This category has the following 2 subcategories, out of 2 total.

Several authors have investigated the predictive values of distinct symptoms and ancillary methods for improving prognoses.

We found that the factors clearly related to better neuropsychological and functional recovery after shunt procedures included the presence of a complete clinical triad, obliterated or normal cortical sulci size, and periventricular lucencies.

Results Clinical Symptoms of NPH Before treatment, 10 patients had the complete clinical triad, one patient had cognitive dysfunction only, and another patient had gait and cognitive disturbances but no sphincter incontinence.

A percentage of change between baseline and postoperative conditions was also calculated as follows: Age, symptom duration, degree of preoperative dementia, and ventricular dilation were not definitively related to neuropsychological or functional changes after surgery when these factors were evaluated by an independent neuropsychologist; however, clinical or radiological factors classically associated with a poor prognosis are increasingly found in patients with suspected NPH or in those who have a mixed-type dementia NPH associated with other hidrocefa,ia disorders such as Alzheimer disease or vascular dementia.

Moreover, the surgical management protocol included other maneuvers before, during, and after shunt placement that could also have influenced the low complication rate and, consequently, the percentage of improvement after shunt insertion. The percentage of B waves that patients with NPH can demonstrate is highly variable; in the present series, we found wide variation in ihdrocefalia percentage of B waves in patients who improved after shunt procedures.

Before treatment, 10 patients had the complete clinical triad, one patient had cognitive dysfunction only, and another patient had gait and cognitive disturbances but no sphincter normotenisva. Our study data partially confirm these results, because traditional prognostic factors cannot help to normotehsiva response to a shunt and thus should not be used as criteria for ruling out shunt surgery in patients with NPH. Outcome hidrocedalia independently assessed by the neurosurgeon and neuropsychologist 6 months after the shunt procedure by hjdrocefalia the NPH scale.