Normal-pressure hydrocephalus: A critical review
Normal-pressure hydrocephalus: A critical review
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DOI：
10.1590/1980-57642018dn13-020001
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发表时间：
2019-06-01
期刊：
影响因子：
--
通讯作者：
Román, Gustavo C.
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文献类型：
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作者：
Oliveira, Louise Makarem;Nitrini, Ricardo;Román, Gustavo C.
常压脑积水（NPH）是一种潜在可逆的综合征，其特征为脑室扩大（脑室扩大）、认知障碍、步态失用症和尿失禁。对特发性和继发性NPH的概念、病理生理学、诊断和治疗进行了严格的回顾。我们使用关键词“常压脑积水”/“特发性常压脑积水”/“继发性常压脑积水”/“NPH”/“脑室腹膜分流”检索了2012年1月至2018年12月的Medline和PubMed数据库。最初的搜索产生了341个匹配结果。经过仔细挑选，共选择了54篇文章，并在撰写本文的过程中纳入了其他相关研究。NPH是老年人潜在可逆性痴呆、频繁福尔斯和复发性尿路感染的重要原因。NPH的临床和影像学特征可能不完整或非特异性，对医生构成诊断挑战，通常需要专家评估，以尽量减少不成功的手术治疗。使用非侵入性MRI方法定量脑血流量，特别是动脉自旋标记（ASL）以及NPH和阻塞性睡眠呼吸暂停（OSA）的频繁关联所带来的最新进展，为理解和治疗NPH提供了新的途径。
Normal-pressure hydrocephalus (NPH) is a potentially reversible syndrome characterized by enlarged cerebral ventricles (ventriculomegaly), cognitive impairment, gait apraxia and urinary incontinence. A critical review of the concept, pathophysiology, diagnosis, and treatment of both idiopathic and secondary NPH was conducted. We searched Medline and PubMed databases from January 2012 to December 2018 using the keywords "normal-pressure hydrocephalus" / "idiopathic normal-pressure hydrocephalus" / "secondary normal-pressure hydrocephalus" / "NPH" / "ventriculoperitoneal shunt". The initial search produced 341 hits. After careful selection, a total of 54 articles were chosen and additional relevant studies were included during the process of writing this article. NPH is an important cause of potentially reversible dementia, frequent falls and recurrent urinary infections in the elderly. The clinical and imaging features of NPH may be incomplete or nonspecific, posing a diagnostic challenge for medical doctors and often requiring expert assessment to minimize unsuccessful surgical treatments. Recent advances resulting from the use of non-invasive MRI methods for quantifying cerebral blood flow, in particular arterial spin-labeling (ASL), and the frequent association of NPH and obstructive sleep apnea (OSA), offer new avenues to understand and treat NPH.