Progress in diagnostic measures for idiopathic normal pressure hydrocephalus: The role of clinical features, neuroimagings, and tap test

Etsuro Mori

Research output: Contribution to journalArticle

Abstract

The symptoms of idiopathic normal pressure hydrocephalus (iNPH) are generally seen in aged, and iNPH has been overlooked or misdiagnosed. In Japan, since the Clinical Guidelines were published, remarkable progress are noted in the recognition of it and clinical researches for it. In this paper, recent progress diagnostic measures for iNPH is discussed, focusing on the key role of clinical features, neuroimagings, and tap test. As for clinical symptoms, in particular the distinctive features of cognitive and behavioral symptoms have been delineated. The clinical significance of MRI features of iNPH, i.e., ventriculomegary with tight high convexty/midline subarachnoid spaces and enlarged Sylvian fissures, have been validated in a prospective cohort study, Study of Idiopathic Normal Pressure Hydrocephalus on Neurological Improvement (SINPHONI). Disproportionately enlarged sub arachnoid-space hydrocephalus (DESH) has been proposed to designate iNPH with these MRI features consisting of a major proportion of iNPH. Although tap test is useful in diagnosis and in making decision of shunt surgery, the results of SINPHONI suggest that its procedure needs to be refined to increase the diagnostic accuracy.

Original languageEnglish
Pages (from-to)960-962
Number of pages3
JournalClinical Neurology
Volume50
Issue number11
DOIs
Publication statusPublished - 2010 Dec 1

Keywords

  • Disproportionately enlarged subarachnoid-space hydrocephalus
  • Idiopathic normal pressure hydrocephalus
  • MRI
  • Symptom
  • Tap test

ASJC Scopus subject areas

  • Clinical Neurology

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