132  Evaluation of the normal pressure hydrocephalus (NPH) service at Wessex Neurological Centre. Issue 6 (27th May 2022)

• Record Type: Journal Article
• Authors: Hopkins, Molly; Jones, Charis; Anwar, Durria-Rubat; Kipps, Christopher; Pengas, George
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 6(2022)
• Page Start: A51
• Page End: A51
• Publication Date: 2022-05-27
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-ABN.165
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: NPH is a condition in which ventriculomegaly occurs due to accumulation of cerebrospinal fluid (CSF). The hallmark symptoms are a triad of abnormal gait, cognitive impairment and urinary inconti- nence. A lumbar puncture (LP) is the main diagnostic test and treatment is via a ventriculoperitoneal shunt. Aim: To evaluate the current service delivered and to identify factors that may improve the identification of patients most likely to benefit from treatment. Method: This is a retrospective study including 126 patients referred between January 2015 and September 2017. From clinical notes, variables were recorded including demographics, imaging, presence of dispro- portionally enlarged subarachnoid spaces (DESH), LP results, CSF Alzheimer's disease (AD) biomarkers, surgery outcome and complications. Results: The shunt success rate was 78.6% and the complication rate was 9.5%. The positive predictive value of an LP and DESH in predicting good shunt outcome was 82.5% and 77.3% respectively. There was no statistical significance between variables assessed and a positive or negative NPH diagnosis. Conclusion: Our service had higher surgical success rates and lower complication rates than stated in literature. The most diagnostically accurate test is a LP, this should be done regardless of DESH. Demo- graphics and CSF biomarker analysis were not diagnostically helpful. [e-mail]