Meyer J S, Kitagawa Y, Tanahashi N, Tachibana H, Kandula P, Cech D A, Clifton G L, Rose J E
J Neurosurg. 1985 Apr;62(4):513-21. doi: 10.3171/jns.1985.62.4.0513.
Ten patients with dementia due to normal-pressure hydrocephalus were evaluated prospectively according to a planned, longitudinal protocol for 4 to 12 months. Information recorded at each visit included clinical history, medical and neurological examination, psychometric scoring by Mini-Mental Status Questionnaire, measurement of ventricular size and local cerebral blood flow, and partition coefficients (local lambda changes) (1 lambda) by xenon contrast computerized tomography scanning. Cerebrospinal fluid shunting was carried out in eight cases. Serial evaluations were repeated at intervals up to 8 months after shunting, and demonstrated that the ventricles decreased in size and periventricular hypodensities decreased. White matter 1 lambda values and blood flows and cortical gray matter flows progressively increased for 3 months after shunting, and remained increased except for one case complicated by chronic alcoholism. Clinical recovery correlated with improved cerebral perfusion. There were returns of urinary continence and improvements in gait and usually in activities of daily living. Mentation was the last factor to improve. Factors negatively influencing cerebral perfusion and clinical recovery were shunt failures and various contributing causes of dementia.
根据一项为期4至12个月的计划纵向方案，对10例正常压力脑积水所致痴呆患者进行了前瞻性评估。每次就诊时记录的信息包括临床病史、医学和神经系统检查、简易精神状态问卷的心理测量评分、脑室大小和局部脑血流量的测量，以及通过氙增强计算机断层扫描获得的分配系数（局部λ变化）（1个λ）。8例患者进行了脑脊液分流术。在分流术后长达8个月的时间间隔内重复进行系列评估，结果显示脑室缩小，脑室周围低密度区减少。分流术后3个月，白质λ值、血流量和皮质灰质血流量逐渐增加，除1例合并慢性酒精中毒的病例外，其余均保持增加。临床恢复与脑灌注改善相关。出现了尿失禁的恢复、步态改善，日常生活活动通常也有所改善。智力是最后改善的因素。对脑灌注和临床恢复产生负面影响的因素包括分流失败和痴呆的各种促成原因。
