Publication: The Outcomes Of Serial Cerebrospinal Fluid Removal In Elderly Patients With Idiopathic Normal Pressure Hydrocephalus.
Loading...
Date
2019-11-19
Authors
Authors
Soysal, PINAR
Kaya, D
Ates, Bulut
Isik, AT
Dokuzlar, O
Journal Title
Journal ISSN
Volume Title
Publisher
Metrics
Abstract
Purpose: Elderly patients with iNPH (idiopathic normal pressure hydrocephalus) might be
potentially high-risk surgical patients. Our purpose was to investigate the outcome of serial
removal of cerebrospinal fluid (CSF) in the patients with iNPH who refused to have the
ventriculoperitoneal or lumboperitoneal shunt surgery or had contraindications to them.
Patients and methods: There were 42 patients, with a median age of 78 years. Recurrent
CSF removal was performed when the patients had deteriorated gait which was defined as
>10% pre-removal change on the average of two walking trials during timed up and go
(TUG). All the patients underwent mini-mental status examination (MMSE), frontal assessment
battery (FAB), Stroop test, Tinetti Performance Oriented Mobility Assessment
(POMA), TUG and nine-hole peg test (NHPT) with the dominant hand, before and after
CSF removal.
Results: Thirty-five patients had two CSF removal procedures with a mean interim period of
7.4 months ranging from 1.5 to 35 months. Thirteen patients had three CSF removal
procedures. The mean TUG scores were decreased after the first, second and third procedures
(p<0.001; p<0.001; p=0.007; respectively). The POMA scores including both gait and
balance components improved after the first and second procedures (p<0.05; for each).
After the third procedure, the increase in POMA-balance score was statistically significant
(p<0.05). After the first procedure, the FAB scores and NHPT scores were significantly
improved (p<0.02). The median follow-up duration of the patients was 34.5 months.
Conclusion: The deterioration of gait disturbance may be improved, and cognitive decline
may be stabilized, at least postponed, by applying recurrent CSF removal in those unshunted
patients with iNPH.
Description
Keywords
Citation
Isik A., Kaya D., Ates B., Dokuzlar O., Soysal P., -The Outcomes Of Serial Cerebrospinal Fluid Removal In Elderly Patients With Idiopathic Normal Pressure Hydrocephalus.-, Clinical interventions in aging, cilt.14, ss.2063-2069, 2019