Samenvatting
Idiopathische Normal Pressure Hydrocephalus (iNPH) wordt gekenmerkt door de trias cognitieve stoornissen, loopstoornissen en urine-incontinentie. De behandeling bestaat uit het plaatsen van een ventriculoperitoneale drain. Onder meer door verschillende onderzoeksmethoden in trials met mogelijk meerdere biasvormen, maar ook eventueel bijkomende neurodegeneratieve aandoeningen, zoals de Ziekte van Alzheimer en vasculaire dementie, zijn er geen goede kwantitatieve noch kwalitatieve gegevens die de lange termijn resultaten van een drain voorspellen. Omdat deze co-morbiditeit medebepalend is of de verwachte winst van een drain opweegt tegen de complicatiekans, is een kritische multidisciplinaire analyse van de co-morbiditeit, kwetsbaarheid én wens van de patiënt voorwaardelijk om te komen tot klinische relevante meerwaarde.
Abstract
Idiopathic Normal Pressure Hydrocephalus (iNPH) is characterized by the clinical triad of cognitive disorders, gait impairment and urinary incontinence. The treatment is the implantation of a ventriculoperitoneal shunt. At present there are still no high quality determinants to predict the long term outcome after shunt implantation, because studies are likely to be biased, use many different study methods and are difficult to interpret by potential concomitant neurodegenerative diseases, like Alzheimer and vascular dementia. Because this comorbidity also determines whether the expected positive outcome of a shunt outweighs the risk of complications, a critical multidisciplinary analysis of comorbidity, frailty and patient preferences is a precondition to realize added value.
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Valckx, W., Duarte Conde, M., Claassen, J. et al. Idiopathische Normale Druk Hydrocephalie en de oudere patiënt. Tijdschr Gerontol Geriatr 46, 168–173 (2015). https://doi.org/10.1007/s12439-015-0123-7
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DOI: https://doi.org/10.1007/s12439-015-0123-7