Anterior callosal angle correlates with gait impairment and fall risk in iNPH patients
| Autor: | Mantovani, P., Giannini, G., Milletti, D., Cevoli, S., Valsecchi, N., Gramegna, L. L., Albini-Riccioli, L., Sturiale, C., Cortelli, P., Lanzino, G., Elder, B. D., Palandri, G., Agati, R., Aspide, R., Calandra-Buonaura, G., Capellari, S., Chiari, L., Ferrari, A., Magelli, E., Merola, M., Oppi, F., Parchi, P., Pirina, A., Piserchia, V. A., Sambati, L. |
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| Přispěvatelé: | Mantovani, Paolo, Giannini, Giulia, Milletti, David, Cevoli, Sabina, Valsecchi, Nicola, Gramegna, Laura Ludovica, Albini-Riccioli, Luca, Sturiale, Carmelo, Cortelli, Pietro, Lanzino, Giuseppe, Elder, Benjamin D, Palandri, Giorgio |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Neurology Idiopathic normal pressure hydrocephalu Corpus callosum Ventriculoperitoneal Shunt 030218 nuclear medicine & medical imaging Corpus Callosum 03 medical and health sciences 0302 clinical medicine Postoperative Complications Idiopathic normal pressure hydrocephalus Internal medicine medicine Humans Anterior callosal angle Gait impairment Tinetti POMA scale Accidental Falls Aged Female Hydrocephalus Normal Pressure Magnetic Resonance Imaging Middle Aged Gait Normal Pressure Neuroradiology medicine.diagnostic_test business.industry Tinetti test Interventional radiology Magnetic resonance imaging eye diseases stomatognathic diseases Cardiology Surgery Neurology (clinical) Neurosurgery business 030217 neurology & neurosurgery Hydrocephalus |
| Zdroj: | Acta neurochirurgica. 163(3) |
| ISSN: | 0942-0940 |
| Popis: | Background In idiopathic normal pressure hydrocephalus (iNPH), gait and balance impairment is the most frequent symptom, and it is often associated with a higher fall risk. In a prior study, the anterior callosal angle (ACA) was validated as a reliable marker to discriminate iNPH from Alzheimer's disease and healthy controls. However, the potential correlation between the ACA with clinical symptoms and functional outcomes has not been assessed. The objective of this study is to determine the utility of the ACA in predicting gait improvement after ventriculoperitoneal (VP) shunting.Methods Patients with probable iNPH who underwent shunt placement at a single institution were prospectively enrolled from May 2015 to May 2019. Patients were assessed preoperatively and at 6 months postoperatively following a standard clinical and MRI protocol. Callosal angle (CA) and ACA were calculated from 3 T MRI preoperatively and at 6 months postoperatively. CA and ACA were tested for correlation with clinical scores.Results Forty-seven patients with probable INPH who completed 6-month postoperative follow-up were enrolled in the study. Baseline ACA was significantly correlated with preoperative fall risk, gait, and balance impairment assessed with Tinetti POMA scale. Additionally, baseline ACA differentiated patients who experienced improvement at Tinetti POMA scale after surgery.Conclusions The baseline ACA is a useful neuroradiological marker to differentiate patients by fall risk and has significant correlation with the improvement in gait and balance impairment following surgery. This study demonstrated that the ACA may be a complementary tool to the CA in predicting shunt responsiveness in iNPH. |
| Databáze: | OpenAIRE |
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