Wolfsegger Thomas, Assar Hamid
Kepler University Hospital, Neuromed Campus, Department of Neurology 1, Linz, Austria.
J Clin Neurosci. 2021 Aug;90:89-93. doi: 10.1016/j.jocn.2021.05.054. Epub 2021 Jun 5.
Comprehensively describe and compare (pre⁄postoperatively) the clinical symptomatology in adult non-communicated hydrocephalus. Associated hydrocephalus signs were analyzed with the idiopathic Normal Pressure Hydrocephalus Scale (iNPH Scale). A standardized clinical scale for non-communicated hydrocephalus is currently not in use.
Ten patients with hydrocephalus occlusus (HO) were analyzed. Hydrocephalus signs were examined with the iNPH Scale in gait, neuropsychology, continence, and balance before and three months after treatment with shunt operation or third endoscopic ventriculostomy.
Patients significantly improved in iNPH total score (25.8%) and gait score (35.4%) three months after neurosurgical intervention. Domain scores in neuropsychology, continence, and balance reached statistical trends (p ≤ 0.066). Most clinical symptoms and signs at baseline improved after surgery (dizziness, lapse of concentration, gait instability, and headache).
Patients with non-communicated HO also showed classical hydrocephalus symptoms as communicated in iNPH patients. The iNPH Scale allows a structured neurological assessment over the disease's progress and surgical intervention. Further studies with a larger patient samples are necessary to support our results.
全面描述并比较成人非交通性脑积水患者术前和术后的临床症状。使用特发性正常压力脑积水量表(iNPH量表)分析相关脑积水体征。目前尚未使用针对非交通性脑积水的标准化临床量表。
分析10例脑积水梗阻(HO)患者。在进行分流手术或第三次内镜下脑室造瘘术治疗前及治疗后3个月,使用iNPH量表对步态、神经心理学、尿失禁和平衡方面的脑积水体征进行检查。
神经外科干预3个月后,患者的iNPH总分(25.8%)和步态评分(35.4%)显著改善。神经心理学、尿失禁和平衡方面的领域评分达到统计学趋势(p≤0.066)。基线时的大多数临床症状和体征在术后得到改善(头晕、注意力不集中、步态不稳和头痛)。
非交通性HO患者也表现出与iNPH患者相同的典型脑积水症状。iNPH量表有助于对疾病进展和手术干预进行结构化的神经学评估。需要进一步纳入更大样本量患者的研究来支持我们的结果。