La Hidrocefalia normotensiva o Hidrocefalia crónica del adultu ye una entidá pocu conocida causada por un aumentu de líquidu cefalorraquídeo, nos. Hidrocefalia de pressão normal (HPN), hidrocefalia normotensiva, hidrocefalia oculta ou síndrome de Hakim-Adams é uma doença neurológica causada pela. Transcript of Hidrocefalia Normotensiva. Logo DESARROLLO Generalidades Definición Condición Neurológica Caracteriza por una.
|Published (Last):||10 November 2008|
|PDF File Size:||13.12 Mb|
|ePub File Size:||6.16 Mb|
|Price:||Free* [*Free Regsitration Required]|
The disease affects three main areas—gait, sphincter control, and cognitive functioning—which were evaluated according to the NPH scale Table 3. Discussion We selected a subgroup of patients who demonstrated four of the most commonly accepted predictors of poor outcome following shunt surgery. Despite the trend toward improvement in attention and verbal memory, only four of the patients presented clinical cognitive amelioration.
Improvements in neuropsychological and behavioral features were analyzed using the percentage of change between baseline and postoperative scores.
All patients had some level of cognitive impairment Table 4. Statistical Analysis Nonparametric analyses were used. The neuropsychological examination included tests of verbal and visual memory, speed of mental processing, and frontal lobe functioning as well as a brief screening test for dementia.
Hidrocefalia Normotensiva by maria sierra on Prezi
Clinically, the patient showed a predominance of gait alterations and urinary incontinence, with subtle recent memory deficit and no other symptomatology. A percentage of change between baseline and normotesiva conditions was also calculated as follows: Many hierocefalia have reported a slight or moderate improvement in patients with NPH following shunt placement; 10, 34 more recently, however, authors have found a high proportion of good results when exhaustive diagnostic and treatment protocols were applied.
The surgical management protocol, which has recently hidrocefalix reported, 24 included several peri- and postoperative maneuvers to minimize secondary complications.
Before treatment, 10 patients had the complete clinical triad, uidrocefalia patient had cognitive dysfunction only, and another patient had gait and cognitive disturbances but no sphincter incontinence. Neuropsychological Assessment and Daily Life Activities Evaluation The neuropsychological examination included tests of verbal and visual memory, speed of mental processing, and frontal lobe functioning as well as a brief screening test for dementia.
Patients’ functional behavior and changes in daily life activities were evaluated using several rating scales: A Delta valve with a performance level of 0.
Although different types of shunt were used in this series, all of them were included in the low-pressure category of valves. To clean the catheter’s lumen and prevent infection, an intraventricular bolus of vancomycin 20 hidrocefalix was administered in all patients. To our knowledge, no study has been focused on the outcome in patients with NPH who show accepted markers of poor prognosis prior to surgery.
The comparisons between the poor prognosis group and the good prognosis group for percentage of change in each clinical and neuropsychological variable showed no significant differences; however, a tendency emerged toward more improvement in patients with poor prognosis in gait functioning NPH gait: Type of Shunt Selected A differential low-pressure valve system was implanted in all patients.
Gait improved in all of the patients who had presented with gait abnormalities at the baseline assessment, sphincter dysfunction improved in nine of 10 patients who had presented with sphincter incontinence at the presurgical hidrocefalla, and cognitive impairment improved in four patients.
In a recent paper, 24 members of our department studied the influence of several known prognostic factors in patients with a confirmed diagnosis of NPH.
Hidrocefalia Normotensiva by Angel Aguado on Prezi
Also administered were the TMT, Parts A and B, 28 to evaluate motor speed, visual scanning, attention, and mental flexibility; a word fluency task consisting of naming as many animals as possible during 1 minute; and the MMSE, 8 which mormotensiva a global measure of the severity of cognitive impairment.
No worsening was observed in any patients Table 5 and Fig. Early or late postsurgical complications were found in two of the 12 patients in the poor prognosis group. A differential low-pressure valve system was implanted in all patients.
Independently of the R out values, patients with active or compensated hydrocephalus were selected for shunt placement. The dura mater was opened by coagulation and as far as possible the size of the hole was limited to the diameter of the ventricular catheter. No statistically significant improvement was found in the cognitive subcomponent Table 6.
Per idrocefalo normoteso s’intende un tipo di idrocefalo comunicante, in cui l’aumento della pressione intracranicadovuto all’accumularsi del liquido cefalorachidianodiventa stabile, e la formazione di liquor si hidrocefalka con l’assorbimento; la pressione intracranica gradualmente diminuisce ma mantiene ancora una livello lievemente elevato. Several normotensiav authors support the view that continuous ICP monitoring is the most useful diagnostic test in evaluating NPH.
Subacute subdural hematoma was diagnosed in a patient before discharge from the hospital.
Surgical Management Protocol The surgical management protocol, which has recently been reported, 24 included several peri- and postoperative maneuvers to minimize secondary complications. In other projects Wikimedia Commons Wikipedia. Consequently, their role normotensica the diagnosis of NPH and prediction of its outcome should be reconsidered. We compared the poor prognosis group with the rest of the sample, which comprised 44 patients with NPH who had undergone shunt placement.
Views View Edit History. Results Clinical Symptoms of NPH Before treatment, 10 patients had the complete clinical triad, one patient had cognitive dysfunction only, and another patient had gait and cognitive disturbances but no sphincter incontinence. Neuropsychological tests and quality-of-life scales were administered to the patients while they were in the hospital for presurgical hixrocefalia, and again 6 months later. In this subgroup of patients, ambulation was started on the 3rd day after shunt insertion.
Light gray barsbefore surgery; dark gray bars6 months after surgery. Eleven of the 12 implanted valves were also combined with an antigravity device, which probably reduced the number of subdural collections in these patients. In our group of patients, cognition improved little in comparison to gait and sphincter changes. Because a small change in the NPH scale score represents a substantial change in the patient’s functional status, we defined moderate improvement as a onepoint increase and marked improvement as an increase of two or more points.
Category:Normal pressure hydrocephalus
All patients had idiopathic hydrocephalus, cortical atrophy, long hideocefalia evolution, and hidrpcefalia in addition, all were old. Sixty-four consecutive patients with suspected NPH, comprehensively described in Poca, et al. Outcome was independently assessed by the neurosurgeon and neuropsychologist 6 months after the shunt procedure by using the NPH scale. Computerized tomography scans left and ICP readings right from a patient with NPH before upper and after lower a shunt procedure.
Several authors have investigated the predictive values hidrocefalja distinct symptoms and ancillary methods for improving prognoses. Subcategories This category has the following 2 subcategories, out of 2 total. Because of this factor and the potential risks of the treatment, some authors still question whether the benefits of shunt insertion outweigh the risks. We selected a subgroup of patients who demonstrated four of the most commonly accepted predictors of poor outcome following shunt surgery.