✓ A series of 40 patients with the syndrome of normal-pressure hydrocephalus is presented. Diagnosis was based on clinical and computerized tomography (CT) scan criteria and was followed by the insertion of a ventriculoperitoneal shunt in every instance. All patients responded favorably to treatment (four of them had a fair outcome), and this response was maintained. There was one postoperative death, but no other serious complications. This study demonstrates that it is possible to diagnose the syndrome of normal-pressure hydrocephalus on the basis of clinical and CT scan criteria without any other invasive investigations. Such patients should respond favorably to an adequately functioning shunting system.
Adams RD: Further observations of normal pressure hydrocephalus. Proc R Soc Med 59:1135–1140, 1966 Adams RD: Further observations of normal pressure hydrocephalus. Proc R Soc Med 59:1135–1140, 1966
Adams RD, , Fisher CM, & Hakim S, et al: Symptomatic occult hydrocephalus with “normal” cerebrospinal fluid pressure. A treatable syndrome. N Engl J Med 273:117–126, 1965 Adams RD, Fisher CM, Hakim S, et al: Symptomatic occult hydrocephalus with “normal” cerebrospinal fluid pressure. A treatable syndrome. N Engl J Med 273:117–126, 1965
Bannister R, , Gilford E, & Kocen R: Isotope encephalography in the diagnosis of dementia due to communicating hydrocephalus. Lancet 2:1014–1017, 1967 Bannister R, Gilford E, Kocen R: Isotope encephalography in the diagnosis of dementia due to communicating hydrocephalus. Lancet 2:1014–1017, 1967
Belloni G, , di Rocco C, & Focacci C, et al: Surgical indications in normotensive hydrocephalus. A retrospective analysis of the relations of some diagnostic findings to the results of surgical treatment. Acta Neurochir 33:1–21, 1976 Belloni G, di Rocco C, Focacci C, et al: Surgical indications in normotensive hydrocephalus. A retrospective analysis of the relations of some diagnostic findings to the results of surgical treatment. Acta Neurochir 33:1–21, 1976
Benson DF, , LeMay M, & Patten DH, et al: Diagnosis of normal-pressure hydrocephalus. N Engl J Med 283:609–615, 1970 Benson DF, LeMay M, Patten DH, et al: Diagnosis of normal-pressure hydrocephalus. N Engl J Med 283:609–615, 1970
Black PM: Idiopathic normal-pressure hydrocephalus. Results of shunting in 62 patients. J Neurosurg 52:371–377, 1980 Black PM: Idiopathic normal-pressure hydrocephalus. Results of shunting in 62 patients. J Neurosurg 52:371–377, 1980
Black PM: Normal-pressure hydrocephalus. Current understanding of diagnostic tests and shunting. Postgrad Med 71 (2):57–67, 1982 Black PM: Normal-pressure hydrocephalus. Current understanding of diagnostic tests and shunting. Postgrad Med 71(2):57–67, 1982
Børgesen SE, , Gjerris F, & Sørensen SC: Intracranial pressure and conductance to outflow of cerebrospinal fluid in normal pressure hydrocephalus. J Neurosurg 50:489–493, 1979 Børgesen SE, Gjerris F, Sørensen SC: Intracranial pressure and conductance to outflow of cerebrospinal fluid in normal pressure hydrocephalus. J Neurosurg 50:489–493, 1979
Chawla JC, , Hulme A, & Cooper R: Intracranial pressure in patients with dementia and communicating hydrocephalus. J Neurosurg 40:376–380, 1974 Chawla JC, Hulme A, Cooper R: Intracranial pressure in patients with dementia and communicating hydrocephalus. J Neurosurg 40:376–380, 1974
Communicating hydrocephalus. Lancet 2:1011–1012, 1977 (Editorial) Communicating hydrocephalus. Lancet 2:1011–1012, 1977 (Editorial)
Crockard HA, , Hanlon K, & Duda EE, et al: Hydrocephalus as a cause of dementia: evaluation by computerised tomography and intracranial pressure monitoring. J Neurol Neurosurg Psychiatry 40:736–740, 1977 Crockard HA, Hanlon K, Duda EE, et al: Hydrocephalus as a cause of dementia: evaluation by computerised tomography and intracranial pressure monitoring. J Neurol Neurosurg Psychiatry 40:736–740, 1977
DeLand FH, , James AE Jr, & Ladd DJ, et al: Normal pressure hydrocephalus: a histologic study. Am J Clin Pathol 58:58–63, 1972 DeLand FH, James AE Jr, Ladd DJ, et al: Normal pressure hydrocephalus: a histologic study. Am J Clin Pathol 58:58–63, 1972
Di Rocco C, , Di Trapani G, & Maira G, et al: Anatomo-clinical correlations in normotensive hydrocephalus. Reports on three cases. J Neurol Sci 33:437–452, 1977 Di Rocco C, Di Trapani G, Maira G, et al: Anatomo-clinical correlations in normotensive hydrocephalus. Reports on three cases. J Neurol Sci 33:437–452, 1977
Earnest MP, , Fahn S, & Karp JH, et al: Normal pressure hydrocephalus and hypertensive cerebrovascular disease. Arch Neurol 31:262–266, 1974 Earnest MP, Fahn S, Karp JH, et al: Normal pressure hydrocephalus and hypertensive cerebrovascular disease. Arch Neurol 31:262–266, 1974
Epstein CM: The distribution of intracranial forces in acute and chronic hydrocephalus. J Neurol Sci 21:171–180, 1974 Epstein CM: The distribution of intracranial forces in acute and chronic hydrocephalus. J Neurol Sci 21:171–180, 1974
Fisher CM: The clinical picture in occult hydrocephalus. Clin Neurosurg 24:270–284, 1977 Fisher CM: The clinical picture in occult hydrocephalus. Clin Neurosurg 24:270–284, 1977
Fisher CM: Communicating hydrocephalus. Lancet 1:37, 1978 (Letter) Fisher CM: Communicating hydrocephalus. Lancet 1:37, 1978 (Letter)
Fisher CM: Hydrocephalus as a cause of disturbances of gait in the elderly. Neurology 32:1358–1363, 1982 Fisher CM: Hydrocephalus as a cause of disturbances of gait in the elderly. Neurology 32:1358–1363, 1982
Fisher CM: Lacunar strokes and infarcts: a review. Neurology 32:871–876, 1982 Fisher CM: Lacunar strokes and infarcts: a review. Neurology 32:871–876, 1982
Geschwind N: The mechanism of normal pressure hydrocephalus. J Neurol Sci 7:481–493, 1968 Geschwind N: The mechanism of normal pressure hydrocephalus. J Neurol Sci 7:481–493, 1968
Granholm L: An explanation of the reversible memory defect in hydrocephalus, in Beks JWF, , Bosch DA, & Brock M (eds): Intracranial Pressure III. Berlin/Heidelberg/New York: Springer-Verlag, 1976, pp 173–176 Granholm L: An explanation of the reversible memory defect in hydrocephalus, in Beks JWF, Bosch DA, Brock M (eds): Intracranial Pressure III. Berlin/Heidelberg/New York: Springer-Verlag, 1976, pp 173–176
Greenberg JO, , Shenkin HA, & Adam R: Idiopathic normal pressure hydrocephalus — a report of 73 patients. J Neurol Neurosurg Psychiatry 40:336–341, 1977 Greenberg JO, Shenkin HA, Adam R: Idiopathic normal pressure hydrocephalus — a report of 73 patients. J Neurol Neurosurg Psychiatry 40:336–341, 1977
Greitz T, & Grepe A: Encephalography in the diagnosis of convexity block hydrocephalus. Acta Radiol (Diagn) 11:232–242, 1971 Greitz T, Grepe A: Encephalography in the diagnosis of convexity block hydrocephalus. Acta Radiol (Diagn) 11:232–242, 1971
Guidetti B, & Gagliardi FM: Normal pressure hydrocephalus. Acta Neurochir 27:1–9, 1972 Guidetti B, Gagliardi FM: Normal pressure hydrocephalus. Acta Neurochir 27:1–9, 1972
Guinane JE: Why does hydrocephalus progress? J Neurol Sci 32:1–8, 1977 Guinane JE: Why does hydrocephalus progress? J Neurol Sci 32:1–8, 1977
Gunasekera L, & Richardson AE: Computerized axial tomography in idiopathic hydrocephalus. Brain 100:749–754, 1977 Gunasekera L, Richardson AE: Computerized axial tomography in idiopathic hydrocephalus. Brain 100:749–754, 1977
Hakim S, & Adams RD: The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci 2:307–327, 1965 Hakim S, Adams RD: The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci 2:307–327, 1965
Hartmann A, & Alberti E: Differentiation of communicating hydrocephalus and presenile dementia by continuous recording of cerebrospinal fluid pressure. J Neurol Neurosurg Psychiatry 40:630–640, 1977 Hartmann A, Alberti E: Differentiation of communicating hydrocephalus and presenile dementia by continuous recording of cerebrospinal fluid pressure. J Neurol Neurosurg Psychiatry 40:630–640, 1977
Heinz ER, , Davis DO, & Karp HR: Abnormal isotope cisternography in symptomatic occult hydrocephalus. A correlative isotopic-neuroradiological study in 130 subjects. Radiology 95:109–120, 1970 Heinz ER, Davis DO, Karp HR: Abnormal isotope cisternography in symptomatic occult hydrocephalus. A correlative isotopic-neuroradiological study in 130 subjects. Radiology 95:109–120, 1970
Hiratsuka H, , Tabata H, & Tsuruoka S, et al: Evaluation of periventricular hypodensity in experimental hydrocephalus by metrizamide CT ventriculography. J Neurosurg 56:235–240, 1982 Hiratsuka H, Tabata H, Tsuruoka S, et al: Evaluation of periventricular hypodensity in experimental hydrocephalus by metrizamide CT ventriculography. J Neurosurg 56:235–240, 1982
Hoff J, & Barber R: Transcerebral mantle pressure in normal pressure hydrocephalus. Arch Neurol 31:101–105, 1974 Hoff J, Barber R: Transcerebral mantle pressure in normal pressure hydrocephalus. Arch Neurol 31:101–105, 1974
Hughes CP, , Siegel BA, & Coxe WS, et al: Adult idiopathic communicating hydrocephalus with and without shunting. J Neurol Neurosurg Psychiatry 41:961–971, 1978 Hughes CP, Siegel BA, Coxe WS, et al: Adult idiopathic communicating hydrocephalus with and without shunting. J Neurol Neurosurg Psychiatry 41:961–971, 1978
Illingworth RD, , Logue V, & Symon L, et al: The ventriculoatrial shunt in the treatment of adult hydrocephalus. Results and complications in 101 patients. J Neurosurg 35:681–685, 1971 Illingworth RD, Logue V, Symon L, et al: The ventriculoatrial shunt in the treatment of adult hydrocephalus. Results and complications in 101 patients. J Neurosurg 35:681–685, 1971
Jacobs L, , Conti D, & Kinkel WR, et al: “Normal-pressure” hydrocephalus. Relationship of clinical and radiographic findings to improvement following shunt surgery. JAMA 235:510–512, 1976 Jacobs L, Conti D, Kinkel WR, et al: “Normal-pressure” hydrocephalus. Relationship of clinical and radiographic findings to improvement following shunt surgery. JAMA 235:510–512, 1976
Koto A, , Rosenberg G, & Zingesser LH, et al: Syndrome of normal pressure hydrocephalus: possible relation to hypertensive and arteriosclerotic vasculopathy. J Neurol Neurosurg Psychiatry 40:73–79, 1977 Koto A, Rosenberg G, Zingesser LH, et al: Syndrome of normal pressure hydrocephalus: possible relation to hypertensive and arteriosclerotic vasculopathy. J Neurol Neurosurg Psychiatry 40:73–79, 1977
Laws ER Jr, & Mokri B: Occult hydrocephalus: results of shunting correlated with diagnostic tests. Clin Neurosurg 24:316–333, 1977 Laws ER Jr, Mokri B: Occult hydrocephalus: results of shunting correlated with diagnostic tests. Clin Neurosurg 24:316–333, 1977
LeMay M, & New PFJ: Radiological diagnosis of occult normal-pressure hydrocephalus. Radiology 96:347–358, 1970 LeMay M, New PFJ: Radiological diagnosis of occult normal-pressure hydrocephalus. Radiology 96:347–358, 1970
Lorenzo AV, , Bresnan MJ, & Barlow CF: Cerebrospinal fluid absorption deficit in normal pressure hydrocephalus. Arch Neurol 30:387–393, 1974 Lorenzo AV, Bresnan MJ, Barlow CF: Cerebrospinal fluid absorption deficit in normal pressure hydrocephalus. Arch Neurol 30:387–393, 1974
Mathew NT, , Meyer JS, & Hartmann A, et al: Abnormal cerebrospinal fluid-blood flow dynamics. Implications in diagnosis, treatment, and prognosis in normal pressure hydrocephalus. Arch Neurol 32:657–664, 1975 Mathew NT, Meyer JS, Hartmann A, et al: Abnormal cerebrospinal fluid-blood flow dynamics. Implications in diagnosis, treatment, and prognosis in normal pressure hydrocephalus. Arch Neurol 32:657–664, 1975
McComb JG: Recent research into the nature of cerebrospinal fluid formation and absorption. J Neurosurg 59:369–383, 1983 McComb JG: Recent research into the nature of cerebrospinal fluid formation and absorption. J Neurosurg 59:369–383, 1983
Messert B, & Wannamaker BB: Reappraisal of the adult occult hydrocephalus syndrome. Neurology 24:224–231, 1974 Messert B, Wannamaker BB: Reappraisal of the adult occult hydrocephalus syndrome. Neurology 24:224–231, 1974
Milhorat TH: The third circulation revisited. J Neurosurg 42:628–645, 1975 Milhorat TH: The third circulation revisited. J Neurosurg 42:628–645, 1975
Mori K, , Murata T, & Nakano Y, et al: Periventricular lucency in hydrocephalus on computerized tomography. Surg Neurol 8:337–340, 1977 Mori K, Murata T, Nakano Y, et al: Periventricular lucency in hydrocephalus on computerized tomography. Surg Neurol 8:337–340, 1977
Moseley IF, & Radü EW: Factors influencing the development of periventricular lucencies in patients with raised intracranial pressure. Neuroradiology 17:65–69, 1979 Moseley IF, Radü EW: Factors influencing the development of periventricular lucencies in patients with raised intracranial pressure. Neuroradiology 17:65–69, 1979
Nelson JR, & Goodman SJ: An evaluation of the cerebrospinal fluid infusion test for hydrocephalus. Neurology 21:1037–1053, 1971 Nelson JR, Goodman SJ: An evaluation of the cerebrospinal fluid infusion test for hydrocephalus. Neurology 21:1037–1053, 1971
Ojemann RG: Normal pressure hydrocephalus. Clin Neurosurg 18:337–370, 1971 Ojemann RG: Normal pressure hydrocephalus. Clin Neurosurg 18:337–370, 1971
Ojemann RG, , Fisher CM, & Adams RD, et al: Further experience with the syndrome of “normal” pressure hydrocephalus. J Neurosurg 31:279–294, 1969 Ojemann RG, Fisher CM, Adams RD, et al: Further experience with the syndrome of “normal” pressure hydrocephalus. J Neurosurg 31:279–294, 1969
Pickard JD: Adult communicating hydrocephalus. Br J Hosp Med 27:35–44, 1982 Pickard JD: Adult communicating hydrocephalus. Br J Hosp Med 27:35–44, 1982
Ribadeau-Dumas JL, , Ricou P, & Verdure L, et al: Etude anatomique d'un cas d'hydrocéphalie à pression normale. Neurochirurgie 22:138–145, 1976 Ribadeau-Dumas JL, Ricou P, Verdure L, et al: Etude anatomique d'un cas d'hydrocéphalie à pression normale. Neurochirurgie 22:138–145, 1976
Russell D: Observations on the Pathology of Hydrocephalus. London: Her Majesty's Stationery Office, 1949 Russell D: Observations on the Pathology of Hydrocephalus. London: Her Majesty's Stationery Office, 1949
Salmon JH, & Armitage JL: Surgical treatment of hydrocephalus ex-vacuo. Ventriculoatrial shunt for degenerative brain disease. Neurology 18:1223–1226, 1968 Salmon JH, Armitage JL: Surgical treatment of hydrocephalus ex-vacuo. Ventriculoatrial shunt for degenerative brain disease. Neurology 18:1223–1226, 1968
Shenkin HA, , Greenberg JO, & Grossman CB: Ventricular size after shunting for idiopathic normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 38:833–837, 1975 Shenkin HA, Greenberg JO, Grossman CB: Ventricular size after shunting for idiopathic normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 38:833–837, 1975
Stein SC, & Langfitt TW: Normal-pressure hydrocephalus. Predicting the results of cerebrospinal fluid shunting. J Neurosurg 41:463–470, 1974 Stein SC, Langfitt TW: Normal-pressure hydrocephalus. Predicting the results of cerebrospinal fluid shunting. J Neurosurg 41:463–470, 1974
Symon L, & Dorsch NWC: Use of long-term intracranial pressure measurement to assess hydrocephalic patients prior to shunt surgery. J Neurosurg 42:258–273, 1975 Symon L, Dorsch NWC: Use of long-term intracranial pressure measurement to assess hydrocephalic patients prior to shunt surgery. J Neurosurg 42:258–273, 1975
Symon L, , Dorsch NWC, & Stephens RJ: Pressure waves in so-called low-pressure hydrocephalus. Lancet 2:1291–1292, 1972 Symon L, Dorsch NWC, Stephens RJ: Pressure waves in so-called low-pressure hydrocephalus. Lancet 2:1291–1292, 1972
Symon L, & Hinzpeter T: The enigma of normal pressure hydrocephalus: tests to select patients for surgery and to predict shunt function. Clin Neurosurg 24:285–315, 1977 Symon L, Hinzpeter T: The enigma of normal pressure hydrocephalus: tests to select patients for surgery and to predict shunt function. Clin Neurosurg 24:285–315, 1977
Sypert GW, , Leffman H, & Ojemann GA: Occult normal pressure hydrocephalus manifested by parkinsonism-dementia complex. Neurology 23:234–238, 1973 Sypert GW, Leffman H, Ojemann GA: Occult normal pressure hydrocephalus manifested by parkinsonism-dementia complex. Neurology 23:234–238, 1973
Tator CH, & Murray SA: A clinical, pneumoencephalographic and radioisotopic study of normal-pressure communicating hydrocephalus. Can Med Assoc J 105:573–579, 1971 Tator CH, Murray SA: A clinical, pneumoencephalographic and radioisotopic study of normal-pressure communicating hydrocephalus. Can Med Assoc J 105:573–579, 1971
Vassilouthis J: Cerebrospinal fluid edema. J Neurosurg 58:625–626, 1983 (Letter) Vassilouthis J: Cerebrospinal fluid edema. J Neurosurg 58:625–626, 1983 (Letter)
Vassilouthis J, & Richardson AE: Ventricular dilatation and communicating hydrocephalus following spontaneous subarachnoid hemorrhage. J Neurosurg 51:341–351, 1979 Vassilouthis J, Richardson AE: Ventricular dilatation and communicating hydrocephalus following spontaneous subarachnoid hemorrhage. J Neurosurg 51:341–351, 1979
Weller RO, & Shulman K: Infantile hydrocephalus: clinical, histological, and ultrastructural study of brain damage. J Neurosurg 36:255–265, 1972 Weller RO, Shulman K: Infantile hydrocephalus: clinical, histological, and ultrastructural study of brain damage. J Neurosurg 36:255–265, 1972
White DN, , Wilson KC, & Curry GR, et al: The limitation of pulsatile flow through the aqueduct of Sylvius as a cause of hydrocephalus. J Neurol Sci 42:11–51, 1979 White DN, Wilson KC, Curry GR, et al: The limitation of pulsatile flow through the aqueduct of Sylvius as a cause of hydrocephalus. J Neurol Sci 42:11–51, 1979
Wikkelsø C, , Andersson H, & Blomstrand C, et al: The clinical effect of lumbar puncture in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 45:64–69, 1982 Wikkelsø C, Andersson H, Blomstrand C, et al: The clinical effect of lumbar puncture in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 45:64–69, 1982
Wood JH, , Bartlet D, & James AE Jr, et al: Normal-pressure hydrocephalus: diagnosis and patient selection for shunt surgery. Neurology 24:517–526, 1974 Wood JH, Bartlet D, James AE Jr, et al: Normal-pressure hydrocephalus: diagnosis and patient selection for shunt surgery. Neurology 24:517–526, 1974
Woodford J, , Saunders RL, & Sachs E Jr: Shunt system patency testing by lumbar infusion. J Neurosurg 45:60–65, 1976 Woodford J, Saunders RL, Sachs E Jr: Shunt system patency testing by lumbar infusion. J Neurosurg 45:60–65, 1976
Wyper DJ, , Pickard JD, & Matheson M: Accuracy of ventricular volume estimation. J Neurol Neurosurg Psychiatry 42:345–350, 1979 Wyper DJ, Pickard JD, Matheson M: Accuracy of ventricular volume estimation. J Neurol Neurosurg Psychiatry 42:345–350, 1979
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