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[特发性正常压力脑积水]

[Idiopathic normal pressure hydrocephalus].

作者信息

Gautschi O P, Cadosch D, Stienen M, Hildebrandt G, Fournier J-Y

机构信息

Klinik für Neurochirurgie, Kantonsspital St. Gallen, Rorschacher Strasse 95, St. Gallen.

出版信息

Praxis (Bern 1994). 2009 Aug 12;98(16):893-902. doi: 10.1024/1661-8157.98.16.893.

Abstract

Normal pressure hydrocephalus (NPH) is characterized by the classic triad of symptoms including gait disturbance, urinary incontinence, and dementia. Gait impairment represents the cardinal symptom. NPH is associated with a radiological verifiable ventriculomegaly in the absence of elevated cerebrospinal fluid (CSF) pressure. Because many patients do not present with classical clinical and radiological findings, its diagnosis and management represents a challenge for the general practitioner, neurologist and neurosurgeon. Various supplemental preoperative tests, including lumbar CSF tap test or CSF outflow resistance determination, can improve the accuracy of predicting a response to surgical intervention. CSF shunt results in significant symptoms in the majority of appropriately evaluated patients. The following article discusses clinical aspects, diagnosis and current therapeutic options.

摘要

正常压力脑积水(NPH)的特征是具有步态障碍、尿失禁和痴呆这一经典三联征症状。步态障碍是主要症状。NPH与脑脊液(CSF)压力未升高情况下影像学可证实的脑室扩大有关。由于许多患者没有典型的临床和影像学表现,其诊断和治疗对全科医生、神经科医生和神经外科医生来说都是一项挑战。各种术前补充检查,包括腰椎脑脊液穿刺试验或脑脊液流出阻力测定,可提高预测手术干预反应的准确性。在大多数经过适当评估的患者中,脑脊液分流术可显著改善症状。以下文章将讨论其临床方面、诊断及当前的治疗选择。

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