正常压力脑积水的步态：脑脊液引流试验的特征及影响
Gait in normal pressure hydrocephalus: characteristics and effects of the CSF tap test.
作者信息
Souza Ricardo Krause Martinez de, Rocha Samanta Fabrício Blattes da, Martins Rodrigo Tomazini, Kowacs Pedro André, Ramina Ricardo
机构信息
Instituto de Neurologia de Curitiba, Divisão de Demências e Outros Distúrbios Cognitivos e Comportamentais, Curitiba PR, Brasil.
Instituto de Neurologia de Curitiba, Serviço de Neuropsicologia, Curitiba PR, Brasil.
出版信息
Arq Neuropsiquiatr. 2018 May;76(5):324-331. doi: 10.1590/0004-282X20180037.
INTRODUCTION
Normal pressure hydrocephalus (NPH), described by Hakim and Adams in 1965, is characterized by gait apraxia, urinary incontinence, and dementia. It is associated with normal cerebrospinal fluid (CSF) pressure and ventricular dilation that cannot be attributed to cerebral atrophy.
OBJECTIVES
To evaluate gait characteristics in patients with idiopathic NPH and investigate the effect of the CSF tap test (CSF-TT) on gait.
METHODS
Twenty-five patients diagnosed with probable idiopathic NPH were submitted to the CSF-TT. The procedure aimed to achieve changes in gait parameters.
RESULTS
Fifteen gait parameters were assessed before and after the CSF-TT. Five showed a statistically significant improvement (p < 0.05): walking speed (p < 0.001), cadence (p < 0.001), step length (p < 0.001), en bloc turning (p = 0.001), and step height (p = 0.004).
CONCLUSION
This study demonstrated that gait speed was the most responsive parameter to the CSF-TT, followed by cadence, step length, en bloc turning, and step height.
引言
1965年哈基姆和亚当斯描述的正常压力脑积水（NPH），其特征为步态失用、尿失禁和痴呆。它与正常脑脊液（CSF）压力及不能归因于脑萎缩的脑室扩张有关。
目的
评估特发性NPH患者的步态特征，并研究脑脊液穿刺试验（CSF-TT）对步态的影响。
方法
25例被诊断为可能特发性NPH的患者接受了CSF-TT。该程序旨在实现步态参数的改变。
结果
在CSF-TT前后评估了15个步态参数。其中5个显示出统计学上的显著改善（p<0.05）：步行速度（p<0.001）、步频（p<0.001）、步长（p<0.001）、整块转身（p = 0.001）和步高（p = 0.004）。
结论
本研究表明，步态速度是对CSF-TT最敏感的参数，其次是步频、步长、整块转身和步高。
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