La Hidrocefalia normotensiva o Hidrocefalia crónica del adultu ye una entidá pocu conocida causada por un aumentu de líquidu cefalorraquídeo, nos. Hidrocefalia de pressão normal (HPN), hidrocefalia normotensiva, hidrocefalia oculta ou síndrome de Hakim-Adams é uma doença neurológica causada pela. Transcript of Hidrocefalia Normotensiva. Logo DESARROLLO Generalidades Definición Condición Neurológica Caracteriza por una.

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This factor would explain the poor improvement in cognition in comparison to gait and sphincter changes. The diagnostic criteria used in these patients relies on continuous ICP monitoring. According to the NPH scale, 11 patients showed clinical improvement defined as an increase of 1 hidrofefalia more points on the NPH scale.

Hidrocefalia de pressão normal

Although this procedure restricted us to only 12 patients, the results were highly demonstrative. In this study we selected a subgroup of patients with some of the traditionally accepted predictors of poor outcome.

Subcategories This category has the following 2 subcategories, out of 2 total. Independently of the R out values, patients with active or compensated hydrocephalus were selected for shunt placement.

Views View Edit History. Outcome was independently assessed by the neurosurgeon and neuropsychologist 6 months after the shunt procedure by using the NPH scale. Of the remaining 56 patients with NPH who had received shunts, we selected a subgroup with four of the factors traditionally considered to be markers of poor prognosis: Neuropsychological Assessment and Daily Life Activities Evaluation The neuropsychological examination included tests of verbal and visual memory, speed of mental processing, and frontal lobe functioning as well as a brief screening test for dementia.

Bar graphs demonstrating baseline conditions and clinical conditions after surgery according to the NPH scale. Surgical Management Protocol The surgical management protocol, hidroceflia has recently been reported, 24 included several peri- and postoperative maneuvers to minimize secondary complications. All patients had idiopathic hydrocephalus, cortical atrophy, long disease evolution, and dementia; in addition, all were old.

We compared the poor prognosis group with the rest of the normotenssiva, which comprised 44 patients with NPH who had undergone shunt placement. Clinically, the patient showed a predominance of gait alterations and urinary incontinence, with subtle recent memory deficit and no other symptomatology. Light gray barsbefore surgery; dark gray bars6 months after surgery. Several other authors support the view that continuous ICP monitoring is the most useful diagnostic test in evaluating NPH.

Type of Shunt Selected A differential low-pressure valve system was implanted in all patients. Normoteensiva Complications There was no treatment-related normotensiga. A highly significant improvement was seen in gait and sphincter functioning as well as in almost all daily life activity and functional scales.


Hidrocefalia Normotensiva by maria sierra on Prezi

The surgical field was then painted with Betadine solution and covered with Betadine-soaked gauze strips for at least 3 minutes. By using this site, you agree to the Terms of Use and Privacy Policy. In a recent paper, 24 members of our department studied the influence of several known prognostic factors in patients with a confirmed diagnosis of NPH. The Wilcoxon matched-pairs signed-rank test was used to compare presurgical and postsurgical data. Also administered were the TMT, Parts A and B, 28 to evaluate motor speed, visual scanning, attention, and mental flexibility; a word fluency task consisting of naming as many animals as possible during 1 minute; and the MMSE, 8 which provides a global measure of the severity of cognitive impairment.

Category:Normal pressure hydrocephalus – Wikimedia Commons

Moreover, the normotensica management protocol included other maneuvers before, during, and after shunt placement that could also have influenced the low complication rate and, consequently, the percentage of improvement after shunt insertion. Media in category “Normal pressure hydrocephalus” The following 6 files are in this category, out of 6 total.

To clean the catheter’s lumen and prevent infection, an intraventricular bolus of vancomycin 20 mg was administered in all patients. Sixty-four consecutive patients with suspected NPH, comprehensively described in Poca, et al.

No statistically significant improvement was found in the cognitive subcomponent Table 6. In other hudrocefalia Wikimedia Commons Wikipedia.

Complications in the early postoperative period 1st month after shunt placement and at 6 months after shunt insertion were evaluated by the neurosurgeon in charge of the patient.

Several authors have investigated the predictive values of distinct symptoms and ancillary methods for improving prognoses.

Hidrocefalia normotensiva

Computerized tomography scans left and ICP readings right from a patient with NPH before upper and after lower a shunt procedure. The clinical condition of patients with NPH who present traditionally accepted markers of poor prognosis can improve after surgery especially as regards gait and sphincter controlindicating that the presence of these markers should not be considered as an absolute criterion for ruling out shunt surgery. The surgical management protocol, which has recently been reported, 24 included several peri- and postoperative maneuvers to minimize secondary complications.

Future research on hydrocephalus should always include a detailed clinical description of the sample, with the diagnostic and surgical strategies used. One additional patient had an asymptomatic subdural collection self-limiting hygroma during the months after shunt placement. The percentage of B waves that patients with NPH can demonstrate is highly variable; in the present series, we found wide variation in the percentage of B waves in patients who improved after shunt procedures.


Our study data partially confirm these results, because traditional prognostic factors cannot help to predict response to a shunt and thus should not be used as criteria for ruling out shunt surgery in patients with NPH.

The disease affects three main areas—gait, sphincter control, and cognitive functioning—which were evaluated according to the NPH scale Table 3. The presence of cortical atrophy, dementia, and old age may hidroxefalia raise the probability of the coexistence of other brain diseases.

At discharge, the patients were advised to try to maintain this bed position at home until the first follow-up examination, which was routinely performed approximately 3 months later. We hidroceaflia these results to be related to the diagnostic and treatment protocols used in this study. Because a small change in the NPH scale score represents a substantial change in the patient’s functional status, hidocefalia defined bidrocefalia improvement as a onepoint increase and marked improvement as an increase of two or more points.

Normal pressure hydrocephalus versus atrophy. Before treatment, 10 patients had the complete clinical triad, one patient had cognitive dysfunction only, and another patient had gait and cognitive disturbances but no sphincter incontinence. Patients were administered the WMS, 35 which consists of seven subtests: Therapeutic Evaluation Outcome was independently assessed by the neurosurgeon and neuropsychologist 6 months after the shunt procedure by using the NPH scale.

Normal pressure hydrocephalus Deutsch: The main objective of this paper was to challenge the widespread belief that patients with the classic symptoms or signs of bad outcome cannot improve after shunt procedures, especially when more than one of these signs are present.

The maximum score 15 points indicates normal functioning in the three domains. After shunt placement, this patient experienced marked improvement abnormal but independent and stable gait, normal sphincter control, and fewer self-reported memory problems—all of which persist to date, 8 years after the shunt was inserted. The following factors have traditionally been associated with unfavorable outcome: Because of this factor and the potential risks of the treatment, some authors still question whether the benefits of shunt insertion outweigh the risks.