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Hui Ming Khoo, Haruhiko Kishima, Naoki Tani, Satoru Oshino, Tomoyuki Maruo, Koichi Hosomi, Takufumi Yanagisawa, Hiroaki Kazui, Yoshiyuki Watanabe, Toshio Shimokawa, Toshihiko Aso, Atsushi Kawaguchi, Fumio Yamashita, Youichi Saitoh and Toshiki Yoshimine

, Wachi A , : Guidelines for management of idiopathic normal pressure hydrocephalus . Neurol Med Chir (Tokyo) 48 : Suppl S1 – S23 , 2008 15 Kay BP , DiFrancesco MW , Privitera MD , Gotman J , Holland SK , Szaflarski JP : Reduced default mode network connectivity in treatment-resistant idiopathic generalized epilepsy . Epilepsia 54 : 461 – 470 , 2013 16 Kubo Y , Kazui H , Yoshida T , Kito Y , Kimura N , Tokunaga H , : Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus

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Geir Ringstad, Kyrre Eeg Emblem and Per Kristian Eide

Neurochir Suppl 71 : 340 – 342 , 1998 19 Eide PK : Demonstration of uneven distribution of intracranial pulsatility in hydrocephalus patients . J Neurosurg 109 : 912 – 917 , 2008 20 Eide PK , Saehle T : Is ventriculomegaly in idiopathic normal pressure hydrocephalus associated with a transmantle gradient in pulsatile intracranial pressure? . Acta Neurochir (Wien) 152 : 989 – 995 , 2010 21 Eide PK , Sorteberg W : Association among intracranial compliance, intracranial pulse pressure amplitude and intracranial pressure in patients with

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Sharif Vakili, Dane Moran, Alice Hung, Benjamin D. Elder, Lee Jeon, Hugo Fialho, Eric W. Sankey, Ignacio Jusué-Torres, C. Rory Goodwin, Jennifer Lu, Jamie Robison and Daniele Rigamonti

F irst identified in 1965, 5 idiopathic normal pressure hydrocephalus (iNPH) is a syndrome of progressive neurological deterioration associated with ventricular enlargement but normal cerebrospinal fluid (CSF) pressure on lumbar puncture. 8 Classically, the disease has been associated with a syndromic triad of gait disturbance, urinary incontinence, and cognitive decline, with gait disturbance and one other feature generally required for diagnosis. 9 , 18 , 20 Generally, the diagnosis of iNPH is multifactorial and made through the assessment of clinical

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Amitabh Gupta and Anthony E. Lang

article: both authors. Reviewed final version of the manuscript and approved it for submission: both authors. Administrative/technical/material support: Lang. References 1 Klinge P , Marmarou A , Bergsneider M , Relkin N , Black PM : Outcome of shunting in idiopathic normal-pressure hydrocephalus and the value of outcome assessment in shunted patients . Neurosurgery 57 : 3 Suppl S40 – S52 , 2005 2 Marmarou A , Bergsneider M , Klinge P , Relkin N , Black PM : The value of supplemental prognostic tests for the preoperative

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Enrico Giordan, Giorgio Palandri, Giuseppe Lanzino, Mohammad Hassan Murad and Benjamin D. Elder

D ifferent strategies have been proposed for the treatment of idiopathic normal pressure hydrocephalus (iNPH). Ventriculoperitoneal (VP) or, less commonly, ventriculoatrial (VA) and lumboperitoneal (LP) shunting are the preferred methods for diverting cerebrospinal fluid (CSF). In the past 20 years, endoscopic third ventriculostomy (ETV) has also been suggested as a reasonable alternative, though this is typically recommended when there is evidence of aqueductal stenosis or fourth ventricle outflow obstruction. There are no randomized studies comparing the

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Jakob Petersen, Per Hellström, Carsten Wikkelsø and Åsa Lundgren-Nilsson

: Hellström, Wikkelsø, Lundgren-Nilsson. An abstract of this work was presented orally at Hydrocephalus 2013 Athens, the Fifth Meeting of the International Society of Hydrocephalus and CSF Disorders (ISHCSF), Athens, Greece, July 1, 2013. References 1 Bergsneider M , Black PM , Klinge P , Marmarou A , Relkin N : Surgical management of idiopathic normal-pressure hydrocephalus . Neurosurgery 57 : 3 Suppl S29 – S39 , ii – v , 2005 2 Blomsterwall E , Bilting M , Stephensen H , Wikkelsö C : Gait abnormality is not the only motor

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Dan Farahmand, Terje Sæhle, Per Kristian Eide, Magnus Tisell, Per Hellström and Carsten Wikkelsö

. Neurosurgery 34 : 1110 – 1113 , 1994 5 Boon AJ , Tans JT , Delwel EJ , Egeler-Peerdeman SM , Hanlo PW , Wurzer HA , : Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts . J Neurosurg 88 : 490 – 495 , 1998 6 Delwel EJ , de Jong DA , Dammers R , Kurt E , van den Brink W , Dirven CM : A randomised trial of high and low pressure level settings on an adjustable ventriculoperitoneal shunt valve for idiopathic normal pressure hydrocephalus: results of the Dutch evaluation programme

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Idiopathic normal-pressure hydrocephalus

Results of shunting in 62 patients

Peter McL. Black

considered improved to some extent by a shunting procedure: 27.4% were able to return to normal work with mild or no deficit, 14.5% had “fair” improvement, and 4.8% were worse; 40.3% were unchanged ( Table 1 ). TABLE 1 Categories of improvement after shunting in 62 patients with idiopathic normal-pressure hydrocephalus Category Percent excellent (return to normal activity) 12.9 good (normal activity, slight deficit) 14.5 fair (improvement but not to normal) 14.5 transient improvement 4.8  total improved

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Massimo Marianetti, Concetta Mina, Massimo Miscusi, Filippo Maria Polli and Paolo Missori

Object The diagnosis and management of idiopathic normal-pressure hydrocephalus (NPH) remains controversial, particularly in selecting patients for shunt insertion. The use of clinical criteria coupled with imaging studies has limited effectiveness in predicting shunt success. The goal of this prospective study was to assess the usefulness of clinical criteria together with brain imaging studies, resistance testing, and external lumbar drainage (ELD) of cerebrospinal fluid (CSF) in determining which patients would most likely benefit from shunt surgery

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Eun-Hyoung Park, Per Kristian Eide, David Zurakowski and Joseph R. Madsen

intracranial pressure recordings using a new method of processing intracranial pressure signals . Pediatr Neurosurg 41 : 122 – 130 , 2005 6 Eide PK : Comparison of simultaneous continuous intracranial pressure (ICP) signals from ICP sensors placed within the brain parenchyma and the epidural space . Med Eng Phys 30 : 34 – 40 , 2008 7 Eide PK : Intracranial pressure parameters in idiopathic normal pressure hydrocephalus patients treated with ventriculoperitoneal shunts . Acta Neurochir (Wien) 148 : 21 – 29 , 2006 8 Eide PK : A new method for