Idiopathic normal-pressure hydrocephalus: evaluation and findings in a multidisciplinary memory clinic
Idiopathic normal-pressure hydrocephalus: evaluation and findings in a multidisciplinary memory clinic
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DOI：
10.1046/j.1468-1331.2001.00291.x
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发表时间：
2001-11-01
影响因子：
5.1
通讯作者：
Juhler, M
中科院分区：
文献类型：
--
作者：
Bech-Azeddine, R;Waldemar, G;Juhler, M
可能患有特发性正常压力脑积水（INPH）的患者的诊断评价传统上在神经科、神经外科或精神科进行。诊断程序和结果在71例连续的临床和放射学怀疑INPH到我们的门诊多学科记忆诊所的患者进行了评价。确定了主要诊断和被认为是次要疾病的潜在伴随疾病。脑室内压力监测和输液试验显示的异常流体动力学是诊断INPH的必要条件。平均年龄为68岁，平均简易精神状态检查（MMSE）评分为22。42%的患者符合DSM IV痴呆标准。在一半的转诊患者（n = 36）中，在门诊进行评估项目后，INPH的怀疑已经被证明是错误的。主要的初步诊断是脑血管疾病（CVD），占转诊病例的27%（n = 19），而INPH仅占20%（n = 14）。分流改善率为72%。其余患者被诊断为患有26种不同疾病之一。多种疾病与INPH综合征相似，CVD是主要鉴别诊断。在门诊多学科记忆诊所评估可能患有INPH的患者是一种有效和合理的诊断方法。
The diagnostic evaluation of patients with possible idiopathic normal-pressure hydrocephalus (INPH) is traditionally performed in the settings of either neurological, neurosurgical or psychiatric departments. The diagnostic procedure and findings in 71 consecutive patients referred with a clinical and radiological suspicion of INPH to our out-patient multidisciplinary memory clinic are evaluated. Primary diagnoses and potential concomitant disorders considered of secondary importance for the symptomatologies were established. Abnormal hydrodynamics, demonstrated by intraventricular pressure monitoring and infusion test were mandatory for the diagnosis of INPH. Mean age was 68 years and mean Mini-Mental State Examination (MMSE) score was 22. DSM IV criteria of dementia were fulfilled in 42%. In half of the referred patients (n = 36), the suspicion of INPH was already disproved subsequently to the evaluation programme performed in the outpatient clinic. The main primary diagnosis was cerebrovascular disease (CVD) comprising 27% (n = 19) of the referrals, whereas INPH was diagnosed in only 20% (n = 14). Shunt improvement rate was 72%. The remaining patients were diagnosed as having one of 26 different conditions. A multiplicity of disorders mimics the INPH syndrome, with CVD being the primary differential diagnosis. Evaluating patients with possible INPH in an outpatient multidisciplinary memory clinic is an effective and rational diagnostic approach.