{"title":"NPH管理的十步:成人脑积水的诊断和治疗进展","authors":"Alex Roman, Prince Takkar, Tanmoy Maiti","doi":"10.1055/s-0043-1774741","DOIUrl":null,"url":null,"abstract":"Abstract Objectives The authors of the present study intend to describe a straightforward protocol for normal pressure hydrocephalus diagnosis and management, with the employment of a multidisciplinary team approach effort. Methods Using a strict methodological approach for initial diagnosis, taking into consideration occupational therapy and physical therapy assessment, the authors have set out to elaborate a simple protocol for suspicion and, once diagnosed, treatment of normal pressure hydrocephalus. We have used the MoCA (Montreal Cognitive Assessment) and walking assessment that included speed, independence, and distance (SID), 10 m walk test, TUG (timed up and go) evaluation, 6-minute Walk Test, MiniBESTest, as the main factors for pre and post lumbar drainage assessment, after which, the alternatives were deliberated and followed, or not, by ventriculoperitoneal shunt insertion. Results The authors have described a protocol, consisting of ten easy steps, which involves a multidisciplinary team, including occupational therapy and physical therapy professionals, as well as neurologists and neurosurgeons for improved and objective assessment prior to insertion of lumbar drain and, thereafter, detecting the population at most benefit for ventriculoperitoneal shunt insertion. We have described the Ten Step Approach for Normal Pressure Hydrocephalus management, including from initial clinical presentation and imaging, to pre and post lumbar drainage, for lastly deciding upon necessity for ventriculoperitoneal shunt insertion. Conclusions A straightforward protocol for normal pressure hydrocephalus seems not only feasible, but simple to implement in most neurosurgical departments, with good accuracy of prediction of lumbar drainage assessment to shunting outcomes.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"44 1","pages":"0"},"PeriodicalIF":0.1000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ten Steps for NPH Management: Advancements in Diagnosis and Treatment of Adult Hydrocephalus\",\"authors\":\"Alex Roman, Prince Takkar, Tanmoy Maiti\",\"doi\":\"10.1055/s-0043-1774741\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Abstract Objectives The authors of the present study intend to describe a straightforward protocol for normal pressure hydrocephalus diagnosis and management, with the employment of a multidisciplinary team approach effort. Methods Using a strict methodological approach for initial diagnosis, taking into consideration occupational therapy and physical therapy assessment, the authors have set out to elaborate a simple protocol for suspicion and, once diagnosed, treatment of normal pressure hydrocephalus. We have used the MoCA (Montreal Cognitive Assessment) and walking assessment that included speed, independence, and distance (SID), 10 m walk test, TUG (timed up and go) evaluation, 6-minute Walk Test, MiniBESTest, as the main factors for pre and post lumbar drainage assessment, after which, the alternatives were deliberated and followed, or not, by ventriculoperitoneal shunt insertion. Results The authors have described a protocol, consisting of ten easy steps, which involves a multidisciplinary team, including occupational therapy and physical therapy professionals, as well as neurologists and neurosurgeons for improved and objective assessment prior to insertion of lumbar drain and, thereafter, detecting the population at most benefit for ventriculoperitoneal shunt insertion. We have described the Ten Step Approach for Normal Pressure Hydrocephalus management, including from initial clinical presentation and imaging, to pre and post lumbar drainage, for lastly deciding upon necessity for ventriculoperitoneal shunt insertion. Conclusions A straightforward protocol for normal pressure hydrocephalus seems not only feasible, but simple to implement in most neurosurgical departments, with good accuracy of prediction of lumbar drainage assessment to shunting outcomes.\",\"PeriodicalId\":42205,\"journal\":{\"name\":\"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia\",\"volume\":\"44 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.1000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0043-1774741\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0043-1774741","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
摘要目的本研究的作者旨在通过多学科团队的努力,描述一个简单的常压脑积水诊断和治疗方案。方法采用严格的初步诊断方法,考虑到职业治疗和物理治疗评估,作者制定了一套简单的怀疑方案,一旦确诊,治疗常压性脑积水。我们使用MoCA (Montreal Cognitive Assessment)和步行评估(包括速度、独立性和距离(SID))、10米步行测试、TUG (timed up and go)评估、6分钟步行测试、MiniBESTest作为腰椎引流评估前后的主要因素,之后,考虑备选方案并随后或不进行脑室-腹膜分流器插入。结果作者描述了一个由十个简单步骤组成的方案,涉及一个多学科团队,包括职业治疗和物理治疗专业人员,以及神经学家和神经外科医生,在腰椎引流管插入之前进行改进和客观评估,然后检测脑室-腹膜分流管插入的最大受益人群。我们描述了常压脑积水治疗的十步方法,包括从最初的临床表现和影像学,到腰椎引流前后,最后决定是否需要脑室腹腔分流术。结论常压性脑积水的简易治疗方案不仅可行,而且易于在大多数神经外科实施,腰椎引流评估对分流结果的预测准确度较高。
Ten Steps for NPH Management: Advancements in Diagnosis and Treatment of Adult Hydrocephalus
Abstract Objectives The authors of the present study intend to describe a straightforward protocol for normal pressure hydrocephalus diagnosis and management, with the employment of a multidisciplinary team approach effort. Methods Using a strict methodological approach for initial diagnosis, taking into consideration occupational therapy and physical therapy assessment, the authors have set out to elaborate a simple protocol for suspicion and, once diagnosed, treatment of normal pressure hydrocephalus. We have used the MoCA (Montreal Cognitive Assessment) and walking assessment that included speed, independence, and distance (SID), 10 m walk test, TUG (timed up and go) evaluation, 6-minute Walk Test, MiniBESTest, as the main factors for pre and post lumbar drainage assessment, after which, the alternatives were deliberated and followed, or not, by ventriculoperitoneal shunt insertion. Results The authors have described a protocol, consisting of ten easy steps, which involves a multidisciplinary team, including occupational therapy and physical therapy professionals, as well as neurologists and neurosurgeons for improved and objective assessment prior to insertion of lumbar drain and, thereafter, detecting the population at most benefit for ventriculoperitoneal shunt insertion. We have described the Ten Step Approach for Normal Pressure Hydrocephalus management, including from initial clinical presentation and imaging, to pre and post lumbar drainage, for lastly deciding upon necessity for ventriculoperitoneal shunt insertion. Conclusions A straightforward protocol for normal pressure hydrocephalus seems not only feasible, but simple to implement in most neurosurgical departments, with good accuracy of prediction of lumbar drainage assessment to shunting outcomes.