Vascular parkinsonism or idiopathic NPH? New insights from CSF pressure analysis
| Autor: | Alessandra Nicoletti, Mario Zappia, Giorgia Sciacca, Claudia Giliberto, Salvatore Lo Fermo, Ester Reggio, Giovanni Mostile |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pathology Neurology Vascular parkinsonism CSF PRESSURE Dermatology Gastroenterology 030218 nuclear medicine & medical imaging Diagnosis Differential Pulse wave amplitude 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Parkinsonian Disorders Idiopathic normal pressure hydrocephalus Cerebrospinal Fluid Pressure Internal medicine Medicine Humans Neuroradiology Aged Retrospective Studies Aged 80 and over business.industry General Medicine Hydrocephalus Normal Pressure CSF pressure monitoring 2708 Neurology (clinical) Psychiatry and Mental Health (Idiopathic) normal pressure hydrocephalus Female Neurosurgery Differential diagnosis business 030217 neurology & neurosurgery |
| Popis: | Differential diagnosis between vascular parkinsonism (VP) and idiopathic normal pressure hydrocephalus (iNPH) is particularly challenging due to similar clinical and neuroradiological features. The objective of this study is to differentiate VP with radiological evidence of ventricular enlargement (REVE) from iNPH on the basis of cerebrospinal fluid (CSF) hydrodynamics. CSF pressure components were investigated in patients with a clinical diagnosis of VP and REVE. Data of eight patients (seven men; age 76 ± 3.9 years; disease duration 26.5 ± 15.6 months) were evaluated. CSF opening pressure values were normal in all patients. Also, mean CSF pressure values during short-term monitoring were normal, except in one patient. Four out of the eight patients had raised values of pulse wave amplitude (PWA) during the opening phase (mean ± SD 57.1 ± 19.9 mmH2O), meanwhile during short-term monitoring, seven out of the eight patients showed raised values of mean PWA (76.8 ± 23 mmH2O). We found that most of patients with clinical characteristics of VP and REVE showed elevated PWA during the short-term monitoring of CSF pressure as observed in iNPH patients. Patients clinically identified as VP may be part of the clinical spectrum of iNPH. |
| Databáze: | OpenAIRE |
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