{"title":"常压脑积水的处理。","authors":"Kaisorn L Chaichana, Jeremy K Cutsforth-Gregory","doi":"10.1212/CON.0000000000001569","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This article reviews the preoperative considerations, postoperative complications, and ongoing management of shunts for normal pressure hydrocephalus.</p><p><strong>Latest developments: </strong>The radiographic pattern of disproportionately enlarged subarachnoid space hydrocephalus (DESH) predicts a positive response to permanent CSF diversion. MRI-safe programmable shunt valves allow for fluid drainage adjustment based on patients' symptoms and radiographic images. Endoscopic third ventriculostomy is a viable alternative to shunting for patients with normal pressure hydrocephalus due to aqueductal stenosis.</p><p><strong>Essential points: </strong>Approximately 75% of patients with normal pressure hydrocephalus improve after shunt surgery regardless of shunt type or location. Clinical benefit and complication rates are similar for frontal and parietal ventricular catheter approaches. Acetazolamide is not an effective treatment for normal pressure hydrocephalus.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"840-849"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Management of Normal Pressure Hydrocephalus.\",\"authors\":\"Kaisorn L Chaichana, Jeremy K Cutsforth-Gregory\",\"doi\":\"10.1212/CON.0000000000001569\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This article reviews the preoperative considerations, postoperative complications, and ongoing management of shunts for normal pressure hydrocephalus.</p><p><strong>Latest developments: </strong>The radiographic pattern of disproportionately enlarged subarachnoid space hydrocephalus (DESH) predicts a positive response to permanent CSF diversion. MRI-safe programmable shunt valves allow for fluid drainage adjustment based on patients' symptoms and radiographic images. Endoscopic third ventriculostomy is a viable alternative to shunting for patients with normal pressure hydrocephalus due to aqueductal stenosis.</p><p><strong>Essential points: </strong>Approximately 75% of patients with normal pressure hydrocephalus improve after shunt surgery regardless of shunt type or location. Clinical benefit and complication rates are similar for frontal and parietal ventricular catheter approaches. Acetazolamide is not an effective treatment for normal pressure hydrocephalus.</p>\",\"PeriodicalId\":52475,\"journal\":{\"name\":\"CONTINUUM Lifelong Learning in Neurology\",\"volume\":\"31 3\",\"pages\":\"840-849\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CONTINUUM Lifelong Learning in Neurology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1212/CON.0000000000001569\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CONTINUUM Lifelong Learning in Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1212/CON.0000000000001569","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
Objective: This article reviews the preoperative considerations, postoperative complications, and ongoing management of shunts for normal pressure hydrocephalus.
Latest developments: The radiographic pattern of disproportionately enlarged subarachnoid space hydrocephalus (DESH) predicts a positive response to permanent CSF diversion. MRI-safe programmable shunt valves allow for fluid drainage adjustment based on patients' symptoms and radiographic images. Endoscopic third ventriculostomy is a viable alternative to shunting for patients with normal pressure hydrocephalus due to aqueductal stenosis.
Essential points: Approximately 75% of patients with normal pressure hydrocephalus improve after shunt surgery regardless of shunt type or location. Clinical benefit and complication rates are similar for frontal and parietal ventricular catheter approaches. Acetazolamide is not an effective treatment for normal pressure hydrocephalus.
期刊介绍：
Continue your professional development on your own schedule with Continuum: Lifelong Learning in Neurology®, the American Academy of Neurology" self-study continuing medical education publication. Six times a year you"ll learn from neurology"s experts in a convenient format for home or office. Each issue includes diagnostic and treatment outlines, clinical case studies, a topic-relevant ethics case, detailed patient management problem, and a multiple-choice self-assessment examination.
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