特発性正常圧水頭症の臨床的特徴について : 当科経験症例21例における病型分類と解析(神経内科学教室岩田誠教授退任記念特別号)

概要

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In recent years, the idiopathic normal pressure hydrocephalus (iNPH), whose clinical guidelines were published in 2004 in Japan, has attracted fresh attention from neurologists and neurosurgeons to its clinical conception and condition. We reviewed the clinical manifestation of the 21 cases of iNPH patients and classified them into possible, probable, and definite groups in accordance with the guidelines. Furthermore, we added an evaluation about their prognosis after surgical treatment in shunted cases. Among gait disturbance, cognitive impairment and urinary incontinence as the three main symptoms of iNPH, gait disturbance was present in all cases and was the most common symptom exhibited in the initial phase of the illness. Patients in the possible iNPH group were older than those in the probable group. The duration of their illness tended to be longer in the definite iNPH group than the non-definite iNPH groups. The reactivity of the CSF tap test might be decreased by age-associated involvement of the central nervous and trunk-limb kinetic systems. It might be difficult to predict the reactivity of the CSF tap test and surgical outcome by the duration of illness.
2008-02-25