Bekaert O, Grandjacques B, Hodel J, Nseir R, Decq P
Service de neurochirurgie, groupe hospitalier Albert-Chenevier-Henri-Mondor, Assistance publique-Hôpitaux de Paris, boulevard du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France.
Rev Neurol (Paris). 2010 Feb;166(2):229-34. doi: 10.1016/j.neurol.2009.10.024. Epub 2010 Jan 18.
Normal pressure hydrocephalus must be considered when gait disturbance, cognitive impairment and sphincter disorders are associated. Symptoms of normal pressure hydrocephalus, especially gait disturbance, are potentially curable by surgery. Our paper provides a summary review of gait disorders associated with normal pressure hydrocephalus detailing their characteristics and the best assessment methods. Although the pathogenic mechanisms underlying normal pressure hydrocephalus remain poorly understood, advances in imaging have enabled considerable progress in our fundamental knowledge of the condition. Tapping the cerebrospinal fluid by lumbar puncture or external lumbar drainage remains the diagnostic test and is predictive of a favorable response to surgical treatment. Clinical severity scores validated for walking and for sphincter dysfunction and cognitive disorders provide the best means of assessing each patient's response to treatment.
当步态障碍、认知障碍和括约肌功能障碍同时出现时,必须考虑正常压力脑积水。正常压力脑积水的症状,尤其是步态障碍,有可能通过手术治愈。我们的论文对与正常压力脑积水相关的步态障碍进行了综述,详细阐述了其特征和最佳评估方法。尽管正常压力脑积水的发病机制仍知之甚少,但影像学的进展使我们对该病症的基础知识有了很大进步。通过腰椎穿刺或外部腰椎引流抽取脑脊液仍然是诊断测试,并且可以预测手术治疗的良好反应。针对行走、括约肌功能障碍和认知障碍验证的临床严重程度评分是评估每位患者治疗反应的最佳方法。