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Communicating Hydrocephalus — Diagnosis and Management

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Book cover Cerebral Ischemia and Dementia

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Abstract

In 1965, Hakim and Adams [28,29] described a syndrome of normal pressure hydrocephalus (NPH). Since then, 25 years have passed, but the search for clarity of diagnosis and reliable indices of the prognostic outcome of shunting procedures still occupies our attention. Beneficial results of diversionary procedures for cerebrospinal fluid (CSF) [1,5,22,44,50,55,56,66] have been obtained by many, but difficulties in sorting out patients and disappointing therapeutic results in other series [4,7,8,11,19,37,43,44,45,48,49,51,53,58,61,64,65] have emphasised the continuing need for careful selection before submitting patients to surgery. Our own experiences and those of other workers of a significant proportion of subdural fluid collection following shunt procedures (approaching 10% in the treatment of patients with little evidence of raised pressure in communicating hydrocephalus) was sufficient to convince us that the apparently simple surgical manoeuvre of insertion of a valve system in every patient with marked degree of ventricular dilatation was not desirable surgical management [36,45,57,63].

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References

  1. Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH (1965) Symptomatic occult hydrocephalus with “normal” cerebrospinal fluid prssure, a treatable syndrome. N Engl J Med 273:117–126

    Article  PubMed  CAS  Google Scholar 

  2. Ahlberg J, Norlen L, Blomstrand C, Wikkelso C (1988) Outcome of shunt operation on urinary incontinence in normal pressure hydrocephalus predicted by lumbar puncture. J Neurol Neurosurg Psychiatry 51(1): 105–108

    Article  PubMed  CAS  Google Scholar 

  3. Akai K, Uchigasaki S, Tanaka U, Komatsu A (1987) Normal pressure hydrocephalus. Neuropathological Study. Acta Pathol Jpn 37(1):97–110

    PubMed  CAS  Google Scholar 

  4. Alker GJ Jr, Glassauer FE, Leslie EV (1972) Long term experience with isotope cisternography. JAMA 219:1005–1010

    Article  PubMed  Google Scholar 

  5. Appenzeller O, Salmon JH (1967) Treatment of parenchymatous degeneration of the brain by ventriculo-atrial shunting of the cerebrospinal fluid. J Neurosurg 26:478–483

    Article  PubMed  CAS  Google Scholar 

  6. Bannister R, Gifford E, Kocen R (1967) Isotope encephalography in the diagtnosis of dimential due to communicating hydrocephalus. Lancet: 1110–1117

    Google Scholar 

  7. Bellonic G, di Rocco C, Focacci C, Galli G, Maira G, Rossi GF (1976) Surgical indications in normotensive hydrocephalus; a retrospective analysis of the relations of some diagnostic findings to the results of surgical treatment. Acta Neurochir (Vienna) 33:1–21

    Article  Google Scholar 

  8. Bensen DF (1974) Normal pressure hydrocephalus. A controversial entity. Geriatrics 29:125–128

    Google Scholar 

  9. Brgesen SE, Gjerris F (1987) Relationships between intracranial pressure, ventricular size, and resistance to CSF outflow. J Neurosurg 67(4):535–539

    Article  Google Scholar 

  10. Chawla JC, Hulme A, Cooper R (1974) Intracranial pressure in patients with dementia and communicating hydrocephalus. J Neurosurg 40:376–380

    Article  PubMed  CAS  Google Scholar 

  11. Coblentz JM, Mattis S, Zingesser LH et al. (1973) Presnile dementia: Clinical aspects and evaluation of cerebrospinal fluid dynamics. Arch Neurol 29:299–308

    Article  PubMed  CAS  Google Scholar 

  12. Cooper R, Hulme A (1966) Intracranial pressure and related phenomenia during sleep. J Neurol Neurosurg Psychiatry 29:564–570

    Article  Google Scholar 

  13. Crockard A, Hanlon K, Duda E (1976) Correlation between ventricular fluid pressure (VFP) and computerized tomography (EMI scan) in patients with normal pressure hydrocephalus. ICP, Groningen, p 49

    Google Scholar 

  14. Leland FH, James AE Jr, Wagner HN Jr et al. (1971) Cisternograpohy with 169 Yb-DTPA. J Neucl Med 12:683–689

    Google Scholar 

  15. DiChiro G (1964) Movement of the cerebrospinal fluid in human beings. Nature 204:290–291

    Article  PubMed  CAS  Google Scholar 

  16. DiChiro G (1964) New radiographic and isotopic procedures in neurological diagnosis. JAMA 188:524–529

    Article  PubMed  CAS  Google Scholar 

  17. DiChiro G, Reames PM, Matthews WB (1964) RISA-ventriculography and RISA-cisternography. Neurology (Minneap) 14:185–191

    CAS  Google Scholar 

  18. DiChiro G (1966) Observations on the circulation of the cerebrospinal fluid. Acta Raido (Diagn) [Stockh] 5:988–1002

    CAS  Google Scholar 

  19. DiRocco C, Maira G, Rossi GF, Vignati A (1976) Cerebrospinal fluid pressure studies in normal pressure hydrocephalus and cerebral atrophy. Eur Neurol 14:119–128

    Article  CAS  Google Scholar 

  20. Fleming IFR, Sheppard RH, Turner V (1972) CSF scanning in the evaluation of hydrocephalus, a clinical review of 100 patients. In Harbert JC, McCullogh DC, Lussenhop AJ, DiChiro G, (eds) Cisternography and hydrocephalus. Thomas, Springfield, Ill, pp 261–284

    Google Scholar 

  21. Foldes FF, Arrowood JG (1948) Changes in cerebrospinal fluid pressure under influence of continuous subarachnoid infusion of normal saline. J Clin Invest 17:346–351

    Article  Google Scholar 

  22. Foltz EL, Ward AA (1956) communicating hydrocephalus from subarachnoid bleeding. J Neurosurg 13:546–566

    Article  PubMed  CAS  Google Scholar 

  23. Gjerris A, Werdelin L, Gjerris F, Srenden PS, Rafaelsen OJ, Alling C (1987) CSF-amine metabolites in depression, dementia and controls. Acta Psychiar Scand 75(6):619–628

    Article  CAS  Google Scholar 

  24. Graff-Radford NR, Bodersky JC (1987) Idiopathic normal pressure hydrocephalus and systemic hypertension. Neurology 37(5):868–871

    PubMed  CAS  Google Scholar 

  25. Graff-Radford NR, Rezai K, Godersky JC, Eslinger P, Damasio H, Kircher PT (1987) Regional cerebral blood flow in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 50(12): 16589–16596

    Article  Google Scholar 

  26. Greitz T, Grepe A (1971) Encephalography in the diagnosis of convexity block hydrocephalus. Acta Radiol (Diagn) [Stockh] 11:232–242

    CAS  Google Scholar 

  27. Greitz TV, Grepe AO, Kalmer MS (1969) Pre- and post-operative evaluation of cerebral blood flow in low pressure hydrocephalus. J Neurosurg 31:644–651

    Article  PubMed  CAS  Google Scholar 

  28. Hakim S (1964) Algunas observaciones sobre la presión del L.C.R sindrome hidro-cefalico en el adulto con “presione normal” del L.C.R. Thesis, Faculty of Medicine, University Javeriana, Bogota, Columbia

    Google Scholar 

  29. Hakim S, Adams RD (1965) The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure; observations on cerebrospinal fluid hydrodynamics. J Neurol Sci 2:307–327

    Article  PubMed  CAS  Google Scholar 

  30. Haan J, Thomeer RT (1988) Predictive value of temporary external lumbar drainage in nornal pressure hydrocephalus. Neurosurgery: 22(2):388–391

    Article  PubMed  CAS  Google Scholar 

  31. Hartmann A, Alberti E, Lange D (1980) CBF and CSF pressure in so-called normal pressure hydrocephalus and dementia of other origin. Lechmor H, Meyer JS (eds) Eighth Salzberg conference on cerebral vascular disease. Excerpta Medica, Amsterdam

    Google Scholar 

  32. Hartmann A, Alberti E, Lange D (1976) Cerebral blood flow and cerebrospinal fluid pressure in patients with communicating hydrocephalus. Adv Neurosurg 4

    Google Scholar 

  33. Heinz ER, Davis DO (1972) Clinical radiological, isotopic and pathological correlation in normotensive hydrocephalus. In: Harbert JC, McCullough DC, Luessenhop AJ, DiChiro G (eds) Cisternography and hydrocephalus. Thomas, Springfield, Ill, pp 217–234

    Google Scholar 

  34. Hirai O, Handa H, Kikuchi H, Ishikawa M, Kinuta Y (1988) Continuous lumbar subarachnoid pressure monitoring as an indicator of shunt operation for so-called normal pressure hydrocephalus. No Shinkei Geka 16(10): 1141–1147

    PubMed  CAS  Google Scholar 

  35. Hussey F, Schanzer B, Katzman R (1970) A simple constant-infusion manometric test for measurement of CSF absorption. II. Clinical studies. Neurology (Minneapolis) 20:665–680

    CAS  Google Scholar 

  36. Illingworth RD (1970) Subdural hematoma after the treatment of chronic hydrocephalus by ventriculoclaval shunt. J Neurol Neurosurg Psychiatry 33:95–99

    Article  PubMed  CAS  Google Scholar 

  37. Jacobs L, Conti D, Kinkel WR, Manning EJ (1976) “Normal pressure” hydrocephalus, relationship of clinical and radiographic findings to improvement following shunt surgery. JAMA 235:510–512

    Article  PubMed  CAS  Google Scholar 

  38. Jack CR Jr., Mokri B, Laws ER Jr., Houser OW, Baker HL Jr., Petersen RC (1987) MR findings in normal-pressure hydrocephalus: significance and comparison with other forms of dementia. J Comput Assist Tomogr 11(6):923–931

    Article  PubMed  Google Scholar 

  39. Katzman R, Hussey F (1970) A simple constant-infusion manometric test for measurement of CSF absorption. I rationale and method. Neurology (Minneapolis) 20: 534–544

    CAS  Google Scholar 

  40. Katzman R, Coblentz J, Zingesser LH et al. (1972) Studies of CSF dynamics in histologically verified presenile dementias. Trans Am Neurol Assoc 97:160–164

    Google Scholar 

  41. Kosteljanetz M (1987) Intracranial pressure: cerebrospinal fluid dynamics and pressurevolume relations. Acta Neurol Scan [suppl] 111(4).1–23

    CAS  Google Scholar 

  42. LeMay M, New PF (1970) Radiological diagnosis of occult normal-pressure hydrocephalus. Radiology 96:347–358

    PubMed  CAS  Google Scholar 

  43. Lorenzo AV, Bresnan MJ, Barlow CF (1968) Cerebrospinal fluid absorption deficit in normal pressure hydrocephalus. Arch Neurol 30:387–393

    Article  Google Scholar 

  44. McCullough DC, Harbert JC, DiChiro G et al. (1970) Prognostic criteria for cerebrospinal fluid shunting from isotope cisternography in communicating hydrocephalus. Neurology (Minneapolis) 20:594–598

    CAS  Google Scholar 

  45. Messen B, Wannamaker BB (1974) Reappraisal of the adult occult hydrocephalus syndrome. Neurology (Minneapolis) 24:224–231

    Google Scholar 

  46. Moretti JL, Sergent A, Louarn F, Rancurel G, le Percq M, Flavigny R, Degos JD, Caron JP, le Poncine Lafitte M, Bardy A et al. (1988) Cortical perfusion assessment with 1231-isopropyl amphetamine (1231-IAMP) in normal pressure hydrocephalus (NPH). Eur J Nucl Med 14(2):73–79

    Article  PubMed  CAS  Google Scholar 

  47. Mulrow CD, Feussner JR, Williams BC, Vokaty KA (1987) The value of clinical findings in the detection of normal pressure hydrocephalus. J Gerontol 42(3):277–279

    PubMed  CAS  Google Scholar 

  48. Ojemann RG, Fisher CM, Adams RD (1969) Further experience with the syndrome of “normal” pressure hydrocephalus. J Neurosurg 31:279–294

    Article  PubMed  CAS  Google Scholar 

  49. Ojemann RG (1971) Normal pressure hydrocephalus. Clin Neurosurg 18:237–369

    Google Scholar 

  50. Phillipon J, Ancri D, Pertuiset B (1971) Hydrocephalie à pression normal (enregistrement de la pression étude radiologique, transit isotopique). Rev Neurol (Paris) 125: 347–358

    Google Scholar 

  51. Phillipon J, George B, Visot A, Cophignon J (1976) Subarachnoid infusion test: its value in the prognosis of shunted normal pressure hydrocephalus. JC, p 47, Groningen

    Google Scholar 

  52. Ricou P Contribution à Tétude de l’hydrocephalie à pression normale. Thesis. Faculty of Medicine, University of Paris

    Google Scholar 

  53. Rossi GF, Galli G, Di Rocco C, Maira G, Meglio M, Troncone L (1974) Normotensive hydrocephalus. The relations of pneumoencephalography and isotope cisternography to the results of surgical treatment. Acta Neurochir Vienna 30:69–83

    Article  CAS  Google Scholar 

  54. Rossi GF, Maira G, Anile C (1987) Intracranial pressure behaviour and its relation to the outcome of surgical CSF shunting in normotensive hydrocephalus. Neurol Res 9(3):183–187

    PubMed  CAS  Google Scholar 

  55. Salmon JH (1972) Adult hydrocephalus evaluation of shunt therapy in 80 patients. J Neurosurg 37:423–428

    Article  PubMed  CAS  Google Scholar 

  56. Salmon JH, Armitage JL (1968) Surgical treatment of hydrocephalus ex vacuo: ventriculoatrial shunt for degenerative brain disease. Neurology (Minneapolis) 18:1223–1226

    CAS  Google Scholar 

  57. Samuelson S, Long DM, Chou SN (1972) Subdural hematoma as a complication of shunting procedures for normal pressure hydrocephalus. J Neurosurg 37:548–551

    Article  PubMed  CAS  Google Scholar 

  58. Shenkin HA, Greenberg J, Bouzarth WF et al (1973) Ventricular shunting for relief of senile symptoms. JAMA 225:1468–1489

    Article  Google Scholar 

  59. Sjaastaad O, Skalpe IO, Engeset A (1969) The width of the temporal horn in the differential diagnosis between normal pressure hydrocephalus and hydrocephalus ex vacuo. Neurology (Minneapolis) 19:1087–1093

    Google Scholar 

  60. St-Laurent M (1988) Normal pressure hydrocephalus in geriatric medicine; a challange. J Geriatric Psychiatry Neurol 1(3): 163–168

    Article  CAS  Google Scholar 

  61. Stein SC, Langfitt TW (1974) Normal pressure hydrocephalus. Predicting results of cerebrospinal fluid shunting. J Neurosurg 41:463–470

    Article  PubMed  CAS  Google Scholar 

  62. Symon L, Dorsch NWC, Stephens RJ (1972) Pressure waves in so-called low pressure hydrocephalus. Lancet 2:1291–1292

    Article  PubMed  CAS  Google Scholar 

  63. Symon L, Dorsch NWC (1975) Use of long-term intracranial pressure measurements to assess hydrocephalic patients peior to shunt surgery. J Neurosurg 42:258–273

    Article  PubMed  CAS  Google Scholar 

  64. Trotter JL, Luzecky M, Siegel BA, Gado M (1974) Cerebrospinal fluid infusion test identification of artifacts and correlationb with cisternography and pneumo encephalography. Neurology (Minneapolis) 24:181–186

    CAS  Google Scholar 

  65. Wolinsky JS, Barnes BD, Margolis MT (1973) Diagnostic tests in normal pressure hydrocephalus. Neurology (Minneapolis) 23:706–713

    CAS  Google Scholar 

  66. Wood JH, Bartlett D, James AE, Udvarhelvi G (1974) Normal-pressure hydrocephalus: Diagnosis and patient selection for shunt surgery. Neurology (Minneapolis) 24:517–526

    CAS  Google Scholar 

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Authors and Affiliations

  1. Gough Cooper Department, Institute of Neurology, The National Hospital, Queen Square, London, WC1N 3BG, UK

    L. Symon

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  1. L. Symon
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Editors and Affiliations

  1. Neurologische Universitätsklinik, Sigmund-Freud-Str. 25, W-5300, Bonn 1, Germany

    Alexander Hartmann

  2. Physiologisches Institut der Universität, Im Neuenheimer Feld 326, W-6900, Heidelberg, Germany

    Wolfgang Kuschinsky

  3. Abt. für Pathochemie und Allg. Neurochemie, Pathologisches Institut der Universität, Im Neuenheimer Feld 220-221, W-6900, Heidelberg, Germany

    Siegfried Hoyer

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© 1991 Springer-Verlag Berlin Heidelberg

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Symon, L. (1991). Communicating Hydrocephalus — Diagnosis and Management. In: Hartmann, A., Kuschinsky, W., Hoyer, S. (eds) Cerebral Ischemia and Dementia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76208-6_55

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  • DOI: https://doi.org/10.1007/978-3-642-76208-6_55

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-76210-9

  • Online ISBN: 978-3-642-76208-6

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