Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo - SP, Brazil.
Arq Neuropsiquiatr. 2022 May;80(5 Suppl 1):42-52. doi: 10.1590/0004-282X-ANP-2022-S118.
Normal pressure hydrocephalus (NPH) has been a topic of debate since its introduction in publications. More frequent in the elderly population, it is characterized by gait disturbance, urinary urge incontinence and cognitive decline. Therefore, it is a clinical-radiological entity with relatively common findings for the age group, which together may have greater specificity. Therefore, its diagnosis must be careful for an adequate selection of patients for treatment with ventricular shunt, since the symptoms are potentially reversible. The tap test has a high positive predictive value as a predictor of therapeutic response, but a negative test does not exclude the possibility of treatment. Scientific efforts in recent years have been directed towards a better understanding of NPH and this narrative review aims to compile recent data from the literature in a didactic way for clinical practice.
正常压力脑积水(NPH)自发表以来一直是一个争论的话题。它在老年人群中更为常见,其特征是步态障碍、尿急失禁和认知能力下降。因此,它是一种具有相对常见影像学表现的临床-影像学实体,在该年龄段可能具有更大的特异性。因此,其诊断必须仔细选择适合脑室分流治疗的患者,因为症状是潜在可逆转的。压颈试验作为治疗反应的预测指标具有很高的阳性预测值,但阴性试验并不能排除治疗的可能性。近年来,科学界一直在努力更好地理解 NPH,本叙述性综述旨在以通俗易懂的方式汇编文献中的最新数据,以指导临床实践。