PMID- 31843431
OWN - NLM
STAT- MEDLINE
DCOM- 20200805
LR  - 20200805
IS  - 1532-2653 (Electronic)
IS  - 0967-5868 (Linking)
VI  - 71
DP  - 2020 Jan
TI  - The benefit of delayed reassessment post high-volume CSF removal in the diagnosis 
      of shunt-responsive idiopathic normal-pressure hydrocephalus.
PG  - 32-38
LID - S0967-5868(19)30776-3 [pii]
LID - 10.1016/j.jocn.2019.11.011 [doi]
AB  - The principle aim of the study was to demonstrate the value of performing delayed 
      reassessment in the diagnosis of idiopathic normal-pressure hydrocephalus (iNPH) 
      and selection of suitable candidates for ventriculoperitoneal shunting (VPS). 
      Thirty-one consecutive patients underwent the NPH protocol at the Flinders 
      Medical Centre between March 2017 and November 2018. The protocol involved 
      mobility and cognitive testing with reassessment post high-volume cerebrospinal 
      fluid (CSF) removal at 24 h and 48 h. The Assessment of Quality of Life 6D 
      (AQoL-6D) questionnaire and International Consultation on Incontinence 
      Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) were completed and 
      repeated again at 6 weeks and 6 months post shunting. Results were analysed to 
      determine the significance of delayed reassessment. Twenty patients (64.5%) 
      underwent insertion of a VPS on the basis of objective improvements and specific 
      criteria. Of these, 6 patients (30%) were shunted based on delayed reassessment 
      at 48 h post CSF removal. Continued improvements were seen for all mobility and 
      cognitive tests from baseline to 48 h post CSF removal. At 6 weeks and 6 months 
      post shunting, there was an overall mean improvement in AQoL-6D and ICIQ-UI SF 
      for the cohort and the improvement was also observed in the subgroup of patients 
      who met shunt criteria at 48 h post CSF removal. In the diagnosis of 
      shunt-responsive idiopathic normal-pressure hydrocephalus, delayed reassessment 
      post CSF removal improves sensitivity and is therefore important.
CI  - Crown Copyright (c) 2019. Published by Elsevier Ltd. All rights reserved.
FAU - Tsimiklis, Chrisovalantis
AU  - Tsimiklis C
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia. Electronic address: 
      chrisovalantis.tsimiklis@sa.gov.au.
FAU - Mascarenhas, Annika
AU  - Mascarenhas A
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
FAU - To, Minh-Son
AU  - To MS
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
FAU - Fairley Bishop, Christine
AU  - Fairley Bishop C
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
FAU - Jenkinson, Felicity
AU  - Jenkinson F
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
FAU - Hunt, Gemma
AU  - Hunt G
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
FAU - Knight, Natalie
AU  - Knight N
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
FAU - Harding, Marguerite
AU  - Harding M
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
FAU - Poonnoose, Santosh
AU  - Poonnoose S
AD  - Department of Neurosurgery, Division of Surgery and Perioperative Medicine, 
      Flinders Medical Centre, Adelaide, Australia.
LA  - eng
PT  - Journal Article
DEP - 20191213
PL  - Scotland
TA  - J Clin Neurosci
JT  - Journal of clinical neuroscience : official journal of the Neurosurgical Society 
      of Australasia
JID - 9433352
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Hydrocephalus, Normal Pressure/*diagnosis/*surgery
MH  - Male
MH  - Middle Aged
MH  - Spinal Puncture/*methods
MH  - Treatment Outcome
MH  - *Ventriculoperitoneal Shunt
OTO - NOTNLM
OT  - Diagnosis
OT  - Idiopathic
OT  - Normal-pressure hydrocephalus
OT  - Ventriculoperitoneal shunt
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2019/12/18 06:00
MHDA- 2020/08/06 06:00
CRDT- 2019/12/18 06:00
PHST- 2019/04/18 00:00 [received]
PHST- 2019/08/30 00:00 [revised]
PHST- 2019/11/09 00:00 [accepted]
PHST- 2019/12/18 06:00 [pubmed]
PHST- 2020/08/06 06:00 [medline]
PHST- 2019/12/18 06:00 [entrez]
AID - S0967-5868(19)30776-3 [pii]
AID - 10.1016/j.jocn.2019.11.011 [doi]
PST - ppublish
SO  - J Clin Neurosci. 2020 Jan;71:32-38. doi: 10.1016/j.jocn.2019.11.011. Epub 2019 
      Dec 13.