La Hidrocefalia normotensiva o Hidrocefalia crónica del adultu ye una entidá pocu conocida causada por un aumentu de líquidu cefalorraquídeo, nos. Hidrocefalia de pressão normal (HPN), hidrocefalia normotensiva, hidrocefalia oculta ou síndrome de Hakim-Adams é uma doença neurológica causada pela. Transcript of Hidrocefalia Normotensiva. Logo DESARROLLO Generalidades Definición Condición Neurológica Caracteriza por una.
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All of our patients presented cortical atrophy, which was one of the selection criteria.
Our study data partially confirm these results, because traditional prognostic factors cannot help to predict response to a shunt and thus should not be used as criteria for ruling out shunt surgery in patients with NPH. A low-pressure diaphragm valve American Heyer-Schulte Corp.
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Five patients had active hydrocephalus Fig. The surgical management protocol, which has recently been reported, 24 included several peri- and postoperative maneuvers to minimize secondary complications. Because of this factor and the potential risks of the treatment, some authors still question whether the benefits of shunt insertion outweigh the risks.
Because a small change in the NPH scale score represents a substantial change in the patient’s functional status, we defined moderate improvement as a onepoint increase and marked improvement as an increase of two or more points. Discussion We selected a subgroup of patients who demonstrated four of the most commonly accepted predictors of poor outcome following shunt surgery.
Hidrocefaoia page was last edited on 30 Juneat Excluding these patients from surgery means that progressive deterioration is inevitable and will likely have an adverse effect on the quality of life of many patients and their families. A percentage of change between baseline and postoperative conditions was also calculated as follows: Complications in the early postoperative period 1st month after shunt placement and at 6 months after shunt insertion were evaluated by the neurosurgeon in charge of the patient.
Light gray barsbefore surgery; dark gray bars6 months after surgery. Our results do show that a good outcome can be obtained and that significant surgical complications can be avoided even in this subgroup of patients many of whom would not have been given shunts at other centers.
Hidrocefalia normotensiva – Wikipedia
This factor normotsnsiva explain the poor improvement in cognition in comparison to gait and sphincter changes. A causa di questo equilibrio il paziente non mostra i sintomi classici dell’ipertensione endocranica quali cefaleanausea, vomito o incoscienza.
Accordingly, each patient received one of the following classifications: We uidrocefalia a subgroup of patients who demonstrated four hidrocedalia the most commonly accepted predictors of poor outcome following shunt surgery. Six months after shunt placement, only one patient remained totally dependent SLS Grade 4seven patients required supervision SLS Grades 2 and 3and four patients were independent for daily life activities SLS Grades 0 and 1; Table 4. We compared the poor prognosis group with the rest of the sample, which comprised 44 patients with NPH who normotensvia undergone shunt placement.
The clinical condition of patients with NPH who present traditionally accepted markers of poor prognosis can improve after surgery especially as regards gait and sphincter controlindicating that the presence of these markers should not be considered as an absolute criterion for ruling out shunt surgery.
We registered mean ICP and the presence and percentage of the total recording time of A waves ICP elevations at least 20 mm Hg above the resting line, with abrupt onset and end, and hiddrocefalia between 5 and 20 minutes and B waves 0. Several authors have investigated the predictive values of distinct symptoms and ancillary methods for improving prognoses.
Good outcome in patients with normal-pressure hydrocephalus and factors indicating poor prognosis
All patients had idiopathic hydrocephalus, cortical atrophy, long disease evolution, and dementia; in addition, all were old.
In other projects Wikimedia Commons Wikipedia. Consequently, their role in hiidrocefalia diagnosis of NPH and prediction of its outcome should be reconsidered. Comparison Between Prognosis Groups We compared the poor prognosis group with the rest of the sample, which comprised 44 patients with NPH who had undergone shunt placement.
Tables 1 and 2 show the clinical and demographic description of the 12 patients who met the poor prognosis selection criteria and the rest of the 44 patients who composed the good hidrocfalia group. Despite the trend toward improvement in attention and verbal memory, only four of the patients presented clinical cognitive amelioration. The disease affects three main areas—gait, sphincter control, and cognitive functioning—which were evaluated according to the NPH scale Table 3.
Figure 1 summarizes the selection criteria of patients included in the present study. The decision to implant a shunt was based on continuous ICP monitoring and CSF dynamics studies the R out was determined by Katzman and Hussey’s 14 constant rate infusion test.
Outcome was independently assessed by the neurosurgeon and neuropsychologist 6 months after the shunt procedure by using the NPH scale.
All patients underwent complete neurological, neuroimaging, and neuropsychological evaluations prior to surgery and were reassessed at 6 months postoperation.
Early or late postsurgical complications were found in two of the 12 patients in the poor prognosis group. No statistically significant improvement was found in the cognitive subcomponent Table 6.
Eleven of the 12 implanted valves were also combined with an antigravity device, which probably reduced the number of subdural collections in these patients. CT of Evan’s index.