Practice guideline: Idiopathic normal pressure hydrocephalus: Response to shunting and predictors of response: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

ABSTRACT:

Objective

We evaluated evidence for utility of shunting in idiopathic normal pressure hydrocephalus (iNPH) and for predictors of shunting effectiveness.

Methods

We identified and classified relevant published studies according to 2004 and 2011 American Academy of Neurology methodology.

Results

Of 21 articles, we identified 3 Class I articles.

Conclusions

Shunting is possibly effective in iNPH (96% chance subjective improvement, 83% chance improvement on timed walk test at 6 months) (3 Class III). Serious adverse event risk was 11% (1 Class III). Predictors of success included elevated Ro (1 Class I, multiple Class II), impaired cerebral blood flow reactivity to acetazolamide (by SPECT) (1 Class I), and positive response to either external lumbar drainage (1 Cla

SUBMITTER: Halperin JJ 

PROVIDER: S-EPMC4676757 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature