Edmond J. Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, UHN, Toronto, Ontario, Canada.
Division of Neurology, University of Toronto, Toronto, Ontario, Canada.
Mov Disord. 2020 Nov;35(11):1945-1954. doi: 10.1002/mds.28251. Epub 2020 Sep 22.
Idiopathic normal pressure hydrocephalus is considered common but remains underinvestigated. There are no uniformly accepted diagnostic criteria and therapeutic guidelines. We summarize the accumulated evidence regarding the definition, pathophysiology, diagnosis, and treatment of idiopathic normal pressure hydrocephalus, highlighting the many gaps and controversies, including diagnostic challenges, the frequent association with neurodegeneration and vascular disease, and the many unknowns regarding patient selection and outcome predictors. A roadmap to fill these gaps and solve the controversies around this condition is also proposed. More evidence is required with respect to diagnostic criteria, the value of ancillary testing, prospective population-based studies and novel trial designs. Furthermore, a need exists to develop new advanced options in shunt technology. © 2020 International Parkinson and Movement Disorder Society.
特发性正常压力脑积水被认为很常见，但仍研究不足。目前没有统一的诊断标准和治疗指南。我们总结了关于特发性正常压力脑积水的定义、病理生理学、诊断和治疗的累积证据，强调了许多空白和争议，包括诊断挑战、与神经退行性变和血管疾病的频繁关联，以及关于患者选择和结果预测因素的许多未知因素。还提出了一张路线图来填补这些空白并解决围绕这种情况的争议。需要更多关于诊断标准、辅助检查价值、前瞻性基于人群的研究和新型试验设计的证据。此外，还需要开发分流技术的新高级选择。© 2020 国际帕金森病和运动障碍学会。
