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Section 3 - Diagnosis

Published online by Cambridge University Press:  05 February 2014

Daniele Rigamonti
Affiliation:
The Johns Hopkins University School of Medicine
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Summary

The recently updated Japanese guidelines draw attention to a specific MRI pattern of disproportionately enlarged subarachnoid space hydrocephalus (DESH), believed to be pathognomonic of idiopathic normal pressure hydrocephalus (iNPH). This chapter discusses why establishing the diagnosis of NPH remains a challenge fifty years after its classic description. The original diagnosis of NPH relied upon the presence of mild dementia, gait, and urinary difficulties (Hakim's triad) seen in association with ventriculomegaly on pneumo-encephalogram. More sensitive cognitive evaluation of iNPH patients requires specific tests for the assessment of subcortical frontal lobe deficits such as the Rey Auditory Verbal Learning Test, Stroop test, Grooved Pegboard, Trail Making A and B Test, and digit span test. This diagnostic test provides information about cerebrospinal fluid (CSF) dynamics and predicts outcome. It consists in either removal of CSF accompanied by pre and post functional evaluation, or an infusion (bolus or continuous) test.
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Adult Hydrocephalus , pp. 99 - 174
Publisher: Cambridge University Press
Print publication year: 2014

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  • Diagnosis
  • Edited by Daniele Rigamonti, The Johns Hopkins University School of Medicine
  • Book: Adult Hydrocephalus
  • Online publication: 05 February 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139382816.011
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  • Diagnosis
  • Edited by Daniele Rigamonti, The Johns Hopkins University School of Medicine
  • Book: Adult Hydrocephalus
  • Online publication: 05 February 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139382816.011
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Diagnosis
  • Edited by Daniele Rigamonti, The Johns Hopkins University School of Medicine
  • Book: Adult Hydrocephalus
  • Online publication: 05 February 2014
  • Chapter DOI: https://doi.org/10.1017/CBO9781139382816.011
Available formats
×