Cognitive recovery in idiopathic normal pressure hydrocephalus: a prospective study.
Cognitive recovery in idiopathic normal pressure hydrocephalus: a prospective study.
复制标题
特发性正常压力脑积水的认知恢复：一项前瞻性研究。
作者：
C. Raftopoulos;J. Deleval;C. Chaskis;Anne Leonard;F. Cantraine;Frank Desmyttere;S. Clarysse;J. Brotchi;E. Benzel;V. Henderson
特发性常压脑积水仍然难以治疗。关于分流术是否真的能改善认知功能以及量化颅内压监测（ICP-Mo）是否能预测术后改善率存在争议。一些研究已经引起了人们的注意，缺乏关于这种情况的手术结果的前瞻性研究。我们已经对特发性常压脑积水患者进行了这样的研究，当“高”波（振幅bbb90mmhg）存在时，基于ICP-Mo进行分流。23名患者接受了手术。术前和术后临床状态通过不考虑ICP-Mo结果的定量程序进行评估。96%的患者在1年后明显改善，高波相对频率与改善程度有统计学意义（P < 0.05）。同时，66.6%的分流患者认知功能有明显改善。在这个系列中，分流的并发症被成功地处理，没有残留的缺陷。我们建议使用定量ICP-Mo作为手术和预测改善等级的标准。
Idiopathic normal-pressure hydrocephalus remains difficult to treat. Controversy exists as to whether or not shunting can really improve cognitive functions and whether quantified intracranial pressure monitoring (ICP-Mo) can predict postoperative improvement rates. Several studies have drawn attention to the lack of a prospective study concerning the surgical outcome of this condition. We have performed such a study on idiopathic normal-pressure hydrocephalus patients shunted on the basis of ICP-Mo when "high" waves (amplitude > 9 mm Hg) were present. Twenty-three patients underwent surgery. The preoperative and postoperative clinical states were assessed by a quantitative procedure blind to the ICP-Mo results. A clear postshunting improvement was seen in 96% of the patients at 1 year with a statistically significant correlation between high wave relative frequency and the grade of improvement (P < 0.05). At the same time, 66.6% of shunted patients showed a significant improvement in cognitive functions. Complications of shunting were successfully managed without residual deficits in this series. We recommend the use of quantitative ICP-Mo as a criterion for surgery and to predict the improvement grade.