Advances in Diagnosis and Treatment of Idiopathic Normal Pressure Hydrocephalus: A Systematic Review (2019–2024)
DOI:
https://doi.org/10.58445/rars.2540Keywords:
iNPH, VPS shunt, iNPH RadscaleAbstract
Background
Idiopathic Normal Pressure Hydrocephalus (iNPH) is a neurological disorder primarily affecting the elderly. Gait disturbances, cognitive decline, and urinary incontinence characterize it. Diagnosing iNPH is challenging because its symptoms overlap with those of other conditions, such as Alzheimer’s Disease and Parkinson’s Disease. Accurate and timely diagnosis is crucial for improving patient outcomes.
Methods
A systematic literature review was conducted using PubMed from January 2019 to June 2024. Search terms included “normal pressure hydrocephalus,” “idiopathic normal pressure hydrocephalus,” and “ventriculoperitoneal shunt (VPS).” Of the 1643 initial results, 103 papers were selected for review based on their relevance to iNPH diagnosis, treatment, and clinical outcomes.
Results/Discussion
Several diagnostic tests were evaluated, with the iNPH Radscale showing the highest sensitivity (100%) and specificity (96%) in diagnosing iNPH. For treatment, the ventriculoperitoneal shunt (VPS) has demonstrated significant efficacy in improving symptoms, particularly when surgery is performed within two years of symptom onset. The results emphasize the importance of early intervention and specific diagnostic tools in predicting treatment success.
Conclusion
Diagnosing iNPH requires a combination of clinical assessments and imaging techniques, with the iNPH Radscale being the most reliable. VPS is the preferred treatment, offering substantial symptom relief, mainly when performed early. Future research should focus on improving diagnostic protocols and exploring alternative treatment strategies to enhance patient outcomes.
Keywords: iNPH, VPS shunt, iNPH Radscale
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