Idiopathic normal pressure hydrocephalus: historical context and a contemporary guide.
Idiopathic normal pressure hydrocephalus: historical context and a contemporary guide.
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特发性正常压力脑积水：历史背景和当代指南。
DOI：
10.1136/pn-2021-003291
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发表时间：
2023
影响因子：
2.8
通讯作者：
Carswell C
中科院分区：
文献类型：
--
作者：
Carswell C
特发性正常压力脑积水（NPH）于1965年被描述为一种综合征，其中脑积水发展但脑脊液（CSF）压力正常，导致分流反应性步态失用症，认知障碍和尿失禁。并非所有患者都对分流术有反应，尽管其临床综合征具有适当的放射学特征。这在随后的几十年里引起了关于特发性NPH的大量争论。现在可以理解的是，许多健康的老年人可能会出现无症状交通性脑积水，随着时间的推移，这可能会发展成一种症状性状态，有时会对CSF分流产生反应，但程度不同。本文综述了NPH的历史背景、预测性试验的使用、诊断和治疗特发性NPH的临床证据的现状以及可能的根本原因，为评估具有特发性NPH放射学特征的患者提供当代实用指南。
Idiopathic normal pressure hydrocephalus (NPH) was described in 1965 as a syndrome in which hydrocephalus develops but with a normal cerebrospinal fluid (CSF) pressure, causing shunt-responsive gait apraxia, cognitive impairment and urinary incontinence. Not all patients respond to shunting despite having the clinical syndrome with appropriate radiological features. This has led to considerable debate over subsequent decades regarding idiopathic NPH. It is now understood that asymptomatic communicating hydrocephalus can develop in many healthy older people, and that over time this can develop into a symptomatic state that sometimes responds to CSF shunting, but to a variable extent. This review looks at the historical background of NPH, the use of predictive tests, the current state of clinical evidence for the diagnosis and treatment of idiopathic NPH and the possible underlying causes, to provide a contemporary practical guide for assessing patients with the radiological features of idiopathic NPH.