[Normal-pressure hydrocephalus in adults. Analysis of results and complications following ventriculo-cardiac derivation].

The results of ventriculo-atrial shunting have been analyzed in 37 patients with normal pressure hydrocephalus. The nature and severity of the symptoms and their progression in time, together with the results of computed tomography and clinical response to CSF withdrawal by lumbar puncture, were compared with the outcome after shunting, in order to define reliable prognostic criteria. In the long term, 43% of the patients improved and 30% died. The complication rate was 22%, including primarily subdural hematoma and shunt malfunction. Amongst the symptoms, ataxia responded best to shunting. Clinical improvement after subtraction of lumbar CSF, and demonstration by computed tomography of ventricular dilation with a hypodense area around the frontal horns in the absence of cortical atrophy, were associated with a favorable outcome.