Abstract
Predicting shunt responsiveness in patients with suspected normal pressure hydrocephalus can be a challenging task. A number of supplementary tests have been used to help in this process. Extended lumbar drainage is the most accurate of these tests. In essence, it represents temporary shunting for few days. Not only it helps in predicting who would benefit from shunt insertion, but it will also help in estimating the extent of improvement. However, this test does require hospitalisation for few days, with resulting cost implications and is associated with risk of complications.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Abbreviations
- CSF:
-
Cerebrospinal fluid
- DESH:
-
Disproportionately enlarged subarachnoid space hydrocephalus
- ELD:
-
Extended lumbar drainage
- iNPH:
-
Idiopathic normal pressure hydrocephalus
- MRI:
-
Magnetic resonance imaging
References
Nunn AC, Jones HE, Morosanu CO, Singleton WGB, Williams MA, Nagel SJ, Luciano MG, Zwimpfer TJ, Holubkov R, Wisoff JH, McKhann GM 2nd, Hamilton MG, Edwards RJ. Extended lumbar drainage in idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis of diagnostic test accuracy. Br J Neurosurg. 2021 Jun;35(3):285–91. https://doi.org/10.1080/02688697.2020.1787948. Epub 2020 Jul 9. PMID: 32643967.
Marmarou A, Bergsneider M, Klinge P, Relkin N, Black PM. The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005 Sep;57(3 Suppl):S17–28; discussion ii-v. https://doi.org/10.1227/01.neu.0000168184.01002.60. PMID: 16160426.
Haan J, Thomeer RT. Predictive value of temporary external lumbar drainage in normal pressure hydrocephalus. Neurosurgery. 1988 Feb;22(2):388–91. https://doi.org/10.1227/00006123-198802000-00020. PMID: 3352890.
Walchenbach R, Geiger E, Thomeer RT, Vanneste JA. The value of temporary external lumbar CSF drainage in predicting the outcome of shunting on normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry. 2002 Apr;72(4):503–6. https://doi.org/10.1136/jnnp.72.4.503. PMID: 11909911; PMCID: PMC1737811.
Williams MA, Razumovsky AY, Hanley DF. Comparison of Pcsf monitoring and controlled CSF drainage diagnose normal pressure hydrocephalus. Acta Neurochir Suppl. 1998;71:328–30. https://doi.org/10.1007/978-3-7091-6475-4_95. PMID: 9779221.
Governale LS, Fein N, Logsdon J, Black PM. Techniques and complications of external lumbar drainage for normal pressure hydrocephalus. Neurosurgery. 2008 Oct;63(4 Suppl 2):379–84; discussion 384. https://doi.org/10.1227/01.NEU.0000327023.18220.88. PMID: 18981847.
El Ahmadieh TY, Wu EM, Kafka B, Caruso JP, Neeley OJ, Plitt A, Aoun SG, Olson DM, Ruchinskas RA, Cullum CM, Barnett S, Welch BG, Batjer HH, White JA. Lumbar drain trial outcomes of normal pressure hydrocephalus: a single-center experience of 254 patients. J Neurosurg. 2019 Jan 4;132(1):306–12. https://doi.org/10.3171/2018.8.JNS181059. PMID: 30611143.
Nakajima M, Yamada S, Miyajima M, Ishii K, Kuriyama N, Kazui H, Kanemoto H, Suehiro T, Yoshiyama K, Kameda M, Kajimoto Y, Mase M, Murai H, Kita D, Kimura T, Samejima N, Tokuda T, Kaijima M, Akiba C, Kawamura K, Atsuchi M, Hirata Y, Matsumae M, Sasaki M, Yamashita F, Aoki S, Irie R, Miyake H, Kato T, Mori E, Ishikawa M, Date I, Arai H; research committee of idiopathic normal pressure hydrocephalus. Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus. Neurol Med Chir (Tokyo). 2021 Feb 15;61(2):63–97. https://doi.org/10.2176/nmc.st.2020-0292. Epub 2021 Jan 15. PMID: 33455998; PMCID: PMC7905302.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Toma, A.K. (2023). Extended Lumbar Drainage: Supplementary Test to Diagnose Shunt Responsive iNPH. In: Bradac, O. (eds) Normal Pressure Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-031-36522-5_12
Download citation
DOI: https://doi.org/10.1007/978-3-031-36522-5_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-36521-8
Online ISBN: 978-3-031-36522-5
eBook Packages: MedicineMedicine (R0)