The predictive value of cerebrospinal fluid tap-test in normal pressure hydrocephalus

• Published in: Arquivos de neuro-psiquiatria Vol. 55; no. 2; pp. 179 - 185
• Main Authors: Damasceno, B P, Carelli, E F, Honorato, D C, Facure, J J
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Academia Brasileira de Neurologia - ABNEURO 01.06.1997
• Subjects: Adult; Aged; Aged, 80 and over; Cerebrospinal Fluid; Female; Follow-Up Studies; Humans; Hydrocephalus, Normal Pressure - surgery; Male; Middle Aged; Neuropsychological Tests; NEUROSCIENCES; Predictive Value of Tests; PSYCHIATRY; Spinal Puncture; Ventriculoperitoneal Shunt; lumbar puncture; normal pressure hydrocephalus; cirurgia de "shunt"; shunt surgery; hidrocefalia de pressão normal; punção lombar
• ISSN: 0004-282X; 1678-4227; 1678-4227; 0004-282X
• DOI: 10.1590/s0004-282x1997000200003

Eighteen patients (mean age of 66.5 years) with normal pressure hydrocephalus (NPH) underwent a ventriculo-peritoneal shunt surgery. Prior to operation a cerebrospinal fluid tap-test (CSF-TT) was performed with measurements of gait pattern and psychometric functions (memory, visuo-motor speed and visuo-constructive skills) before and after the removal of 50 ml CSF by lumbar puncture (LP). Fifteen patients improved and 3 were unchanged after surgery. Short duration of disease, gait disturbance preceding mental deterioration, wide temporal horns and small sulci on CT-scan were associated with good outcome after shunting. There was a good correlation between the results of CSF-TT and shunt surgery (chi 2 = 4.11, phi = 0.48, p < 0.05), with gait test showing highest correlation (r = 0.99, p = 0.01). In conclusion, this version of CSF-TT proved to be an effective test to predict improvement after shunting in patients with NPH.