Normal Pressure Hydrocephalus; Outcome after Ventriculoperitoneal Shunt

  • Manzoor Ahmad Department of Neurosurgery, Services Institute of Medical Sciences (SIMS) / Services Hospital, Lahore
  • Ahsan Numan Department of Neurosurgery, Services Institute of Medical Sciences (SIMS) / Services Hospital, Lahore
  • Rizwan Masood Butt Department of Neurosurgery, Services Institute of Medical Sciences (SIMS) / Services Hospital, Lahore
Keywords: Normal pressure hydrocephalus, dementia, ventriculoperitoneal shunt


Background: Normal pressure hydrocephalus (NPH) is a treatable cause of dementia. Hakim and Adams des-cribed for the first time the symptoms and signs of NPH which include ataxia, progressive memory loss and uri-nary incontinence. In properly diagnosed cases, ventriculoperitoneal (VP) shunt leads to good outcome.
Material and Methods: This study comprised of 40 patients with NPH. The duration of study was 5 years from January 2009 to December 2013. The duration of illness before presentation ranged from one year to 6 years. The patients were diagnosed clinically and CT scan brain was done in all patients (MRI in some patients). All patients underwent Folstein Mini-Mental State Examination. In cases of possible NPH, drainage lumbar puncture (LP) was done and their response was noted. In 35 patients whose families gave consent for surgery, VP shunt was done while families of 5 patients refused surgery. The patients who underwent VP shunt were followed up, which ranged from one to 5 years.
Results: The age of the patients was between 52 and 70 years. The majority of patients (25) were between 61-70 years. Out of the 35 patients, 26 (75%) were male while 9 (25%) were female. The initial symptom in all these patients was gait ataxia and the duration of illness ranged from one year to 6 years.
Conclusion: Normal pressure hydrocephalus (NPH) is a treatable cause of dementia. In properly diagnosed pat-ients, ventriculoperitoneal shunt gives good results.


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