Philippon J, Duplessis E, Dorwling-Carter D, Horn Y E, Cornu P
Service de Neurochirurgie, Hôpital de La Salpêtrière.
Rev Neurol (Paris). 1989;145(11):776-80.
Forty six patients who had normal pressure hydrocephalus (NPH) and who presented 2 or more of the 5 following preoperative signs: dementia with gait disturbances and urinary incontinence, gait disturbance as first sign, known etiology, positive lumbar puncture withdrawal test, presence of periventricular hypodensity on CT and absence of visible cerebral sulci, were treated by lumboperitoneal shunt. Postoperative results were evaluated at 1 month, 6 months and 1 year with 60.6 p. 100 of good results. Complications of LP shunts (26 p. 100) were mild and did not compromise the outcome. We emphasize the necessity of clinical selecting criteria before surgery and the value of LP shunt in the treatment of NPH.
46例患有正常压力脑积水(NPH)且术前出现以下5种体征中的2种或更多的患者:伴有步态障碍和尿失禁的痴呆、步态障碍为首发体征、已知病因、腰椎穿刺引流试验阳性、CT显示脑室周围低密度以及脑沟不可见,接受了腰大池-腹腔分流术治疗。在术后1个月、6个月和1年对结果进行评估,60.6%的患者效果良好。腰大池-腹腔分流术的并发症发生率为26%,症状较轻,未影响治疗结果。我们强调术前临床选择标准的必要性以及腰大池-腹腔分流术在NPH治疗中的价值。