Incidence, diagnostic criteria and outcome following ventriculoperitoneal shunting of idiopathic normal pressure hydrocephalus in a memory clinic population: A prospective observational cross-sectional and cohort study
BMJ Open Dec 11, 2019
Razay G, et al. - In this prospective observational cross-section and cohort study of diagnostic accuracy of 408 consecutive people recruited in 2010–2014, experts assessed diagnostic criteria for idiopathic normal pressure hydrocephalus (INPH) among people with memory impairment, and determined the incidence of INPH. The diagnosis of INPH was robustly prognosticated by the presence of balance and/or gait disorders, particularly fear of falling, trouble to stand on toes/heels, urinary disturbances, ventriculomegaly with Evans ratio greater than Combined Diagnostic Threshold, whilst the probability of the diagnosis was decreased by hallucinations and/or delusions and forgetfulness. This triage index test had high sensitivity and specificity. Results suggested that he triage index test score was an easy tool that could be beneficial for physicians to recognize INPH diagnoses and the requirement for referral for shunt surgery, which may enhance cognitive, balance and gait functioning.
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