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E-raamat: Normal Pressure Hydrocephalus: Pathophysiology - Diagnosis - Treatment

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  • Formaat: 164 pages
  • Ilmumisaeg: 14-May-2014
  • Kirjastus: Thieme Publishing Group
  • Keel: eng
  • ISBN-13: 9783132580428
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Normal Pressure Hydrocephalus: Pathophysiology - Diagnosis - TreatmentSuurem pilt
  • Formaat: 164 pages
  • Ilmumisaeg: 14-May-2014
  • Kirjastus: Thieme Publishing Group
  • Keel: eng
  • ISBN-13: 9783132580428
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"Presents information on pathophysiology, diagnosis, and treatment of idiopathic normal pressure hydrocephalus. Highlights the importance of determining the benefits of surgical implantation of a VP shunt. Because NPH is often incorrectly diagnosed with disorders such as Parkinson disease, the challenges faced in accurate diagnosis of NPH are discussed. Describes clinical signs and symptoms, radiographic findings, and diagnostic testing"--Provided by publisher.

Often misunderstood and misdiagnosed, normal pressure hydrocephalus (NPH) is a disease of the elderly that is on the rise as the population ages. Its similarities to Parkinsons disease, dementia and other chronic neurodegenerative conditions make diagnosis challenging, requiring clinicians to be alert to the signs and symptoms that differentiate it.

Here is the first comprehensive book on the topic, written by experts who have researched and taught courses on NPH for years. From clinical characteristics and pathophysiology to signs and symptoms, radiographic findings, diagnostic tests and state-of-the-art treatment techniques, it covers everything practitioners need to know about this multi-faceted condition.

Special Features:

  • Describes the classic symptom triad of gait disturbance, urinary incontinence and dementia
  • Covers the full sequence of the diagnostic work-up, including imaging studies, non-invasive tests, and invasive procedures such as lumbar infusion and cerebrospinal tap tests
  • Explains the risks and benefits of surgical implantation of a ventricular-peritoneal (VP) shunt to relieve symptoms and restore function, including key criteria for evaluating shunt responsiveness
  • Provides the first step-by-step account of operative shunt placement by Dr. Michael Fritsch, who has performed the procedure extensively at leading neurosurgical centers throughout the world

Including troubleshooting techniques following shunt surgery, long-term management of patients, prognosis for the condition and future initiatives, this all-inclusive reference makes a major contribution to the field. It is essential for neurosurgeons, neurologists, internists, residents, and other physicians who treat diseases of the elderly in everyday practice.

Arvustused

This is an excellent book that can be used as a starting point to gain a basic understanding regarding the assessment and management of the adult iNPH patient and would be recommended reading for anyone with an interest in this important topic. -- Neurosurgery-online.com

1 Introduction
2(4)
Michael J. Fritsch
1.1 Why a Book about NPH?
2(4)
2 Epidemiology of Idiopathic Normal Pressure Hydrocephalus
6(4)
Michael J. Fritsch
2.1 Epidemiologic Studies
6(1)
2.1.1 Trenkwalder et al (1995)
6(1)
2.1.2 Tisell et al (2005)
6(1)
2.1.3 Marmarou et al (2007)
6(1)
2.1.4 Hiraoka et al (2008)
6(1)
2.1.5 Brean and Eide (2008)
6(1)
2.1.6 Brean et al (2009)
7(1)
2.1.7 Tanaka et al (2009)
7(1)
2.1.8 Iseki et al (2009)
7(1)
2.1.9 Klassen and Ahlskog (2011)
7(1)
2.2 Discussion
7(1)
2.3 Summary
8(2)
3 History
10(6)
Michael J. Fritsch
3.1 Early History
10(1)
3.2 Hydrocephalus and its Treatment in the 19th and 20th Centuries
10(1)
3.3 Development of Modern Shunt Concepts
11(1)
3.4 Hakim and the Discovery of Normal Pressure Hydrocephalus
12(1)
3.5 Modern Shunt Technology and Perspectives
13(3)
4 Clinical Characteristics and Differential Diagnosis
16(8)
Uwe Kehler
4.1 Natural History
16(1)
4.2 Symptoms of iNPH
16(2)
4.2.1 Main Symptoms
16(1)
4.2.2 Other Symptoms
17(1)
4.3 Differential Diagnosis
18(3)
4.3.1 Secondary NPH and Chronic Obstructive Hydrocephalus
18(1)
4.3.2 Parkinson Disease
19(1)
4.3.3 Alzheimer Disease
20(1)
4.3.4 Binswanger Disease (Subcortical Vascular Dementia)
20(1)
4.3.5 Brain Atrophy
20(1)
4.3.6 Cervical Myelopathy
21(1)
4.3.7 Lumbar Spinal Canal Stenosis
21(1)
4.4 Summary
21(3)
5 Pathophysiology
24(4)
Johannes Lemcke
Ullrich Meier
5.1 What Causes iNPH? Theories Proposed by the Discoverers and the Bulk Flow Theory
24(1)
5.2 Inner Contradictions
25(3)
6 Noninvasive Diagnostic Work-up
28(8)
Uwe Kehler
6.1 Evaluation of the Patient's Medical History
28(1)
6.2 Clinical Examination
28(5)
6.2.1 Evaluating Gait Disturbance
28(1)
6.2.2 Evaluating Incontinence
29(1)
6.2.3 Neuropsychological Testing
29(4)
6.3 Summary
33(3)
7 Imaging
36(10)
Johannes Lemcke
7.1 Computed Tomography
36(1)
7.2 Subjective Assessment of Ventricular Size and Shape
36(1)
7.3 Indices
36(2)
7.3.1 Evans Index
36(1)
7.3.2 Other Indices
36(1)
7.3.3 Third Ventricle Diameter
37(1)
7.4 MRI/Phase-Contrast MRI
38(1)
7.5 Diffusion Tensor Imaging
38(1)
7.6 Multifrequency Magnetic Resonance Elastography
39(1)
7.7 Direct Postoperative Imaging
39(1)
7.8 Imaging for Routine Follow-Up
39(1)
7.9 Native Radiography/Valve Setting
39(2)
7.10 Using Imaging for Troubleshooting
41(5)
7.10.1 Overdrainage
41(1)
7.10.2 Underdrainage
42(4)
8 Invasive Diagnostic Work-up
46(12)
Johannes Lemcke
Ullrich Meier
8.1 Intracranial Pressure Monitoring
46(1)
8.2 Lumbar Infusion Test
46(5)
8.2.1 Outflow Resistance
47(1)
8.2.2 Calculation Procedure
48(2)
8.2.3 Dynamic Infusion Test Within the Investigation Chain
50(1)
8.3 CSF Tap Test
51(1)
8.4 External Lumbar Drainage
52(1)
8.5 CSF and Serum Biochemical Tests
52(1)
8.6 Diagnostic Pathway
53(5)
9 Shunt and Valve Technology
58(28)
Christoph Miethke
9.1 Definition
58(1)
9.2 Types
58(1)
9.3 Physical Basics
58(1)
9.4 Hydrostatic Pressure
58(1)
9.5 Physics of Ventriculoperitoneal Shunts
59(2)
9.6 Ventriculoatrial Shunts
61(1)
9.7 Classification of Valves
61(3)
9.8 Adjustable Differential Pressure Valves
64(3)
9.9 Hydrostatic Devices
67(19)
9.9.1 Adjustable Hydrostatic Devices
77(9)
10 Shunt and Valve Settings
86(8)
Michael J. Fritsch
Uwe Kehler
Johannes Lemcke
Ullrich Meier
10.1 Shunt Settings
86(1)
According to M.F.
10.2 Shunt Settings
86(3)
According to U.K.
10.2.1 Ventriculoatrial versus Ventriculoperitoneal Shunt
86(1)
10.2.2 Frontal versus Parietal/Occipital Bore Hole
87(1)
10.2.3 Selection of Valve Opening Pressure
88(1)
10.2.4 Should the Valve and/or the Gravitational Device be Programmable?
88(1)
10.2.5 Shunt Configuration (with or without a Cerebrospinal Fluid Reservoir)
88(1)
10.2.6 Selecting Catheter Material
89(1)
10.2.7 The "Optimal" Shunt Setting
89(1)
10.3 Shunt Settings
89(2)
According to U.M. and J.L.
10.3.1 Why Use Gravitational Valves?
89(1)
10.3.2 Does Valve Opening Pressure of Hydrostatic Valves Have an Influence on the Course of the Disease?
90(1)
10.3.3 Conclusion regarding Clinical Practice
91(1)
10.4 Efficiency of Gravitational Valves
91(3)
10.4.1 Conclusion
92(2)
11 Surgical Technique
94(8)
Michael J. Fritsch
11.1 Settings in the Operating Room
94(1)
11.2 Positioning
94(1)
11.3 Shaving and Disinfection
94(1)
11.4 Draping
94(1)
11.5 Surgical Procedure
95(4)
11.5.1 Ventricular Catheter
95(1)
11.5.2 Valve
96(2)
11.5.3 Peritoneal Catheter
98(1)
11.6 Alternatives to the VP Shunt
99(3)
12 Endoscopic Third Ventriculostomy in Normal Pressure Hydrocephalus
102(8)
Uwe Kehler
12.1 Rationale for ETV in Communicating Hydrocephalus and NPH
102(1)
12.1.1 ETV in Shunt Failure
103(1)
12.2 Technique
103(3)
12.2.1 Preoperative Planning
103(1)
12.2.2 Positioning of the Patient
104(1)
12.2.3 Surgical Technique
104(2)
12.3 Complications
106(1)
12.4 Outcomes
107(1)
12.5 Summary
107(3)
13 Scales and Scores
110(6)
Ullrich Meier
13.1 Black Grading Scale
110(1)
13.2 Index for Postoperative Improvement
110(1)
13.3 Stein-Langfitt Scale
111(1)
13.4 Kiefer Grading Scale
111(1)
13.5 NPH Recovery Rate
111(1)
13.5.1 Conclusion
112(1)
13.6 Comorbidity Index
112(4)
14 Follow-up Management of Idiopathic Normal Pressure Hydrocephalus
116(4)
Ullrich Meier
14.1 Organizing Follow-up Examinations
116(1)
14.2 Follow-up Intervals
116(1)
14.2.1 One/Three Months
116(1)
14.2.2 Six Months
116(1)
14.2.3 Twelve Months
116(1)
14.3 Should Follow-ups End?
117(3)
15 Complications
120(22)
Michael J. Fritsch
Uwe Kehler
Johannes Lemcke
Ullrich Meier
15.1 Intraoperative Complications
120(1)
15.2 Infections
121(7)
15.2.1 What is a Shunt Infection?
121(1)
15.2.2 Shunt Colonization
122(1)
15.2.3 Shunt-Related CSF Infection/Meningitis
123(1)
15.2.4 Shunt-Related Peritonitis/Abdominal Abscess
123(1)
15.2.5 Epidemiology of Shunt Infections in Patients With iNPH
123(1)
15.2.6 Does My Patient Have a Shunt Infection?
124(1)
15.2.7 How Can Shunt Infections Be Avoided iniNPH?
125(1)
15.2.8 How Can Shunt-Related Infections Be Treated?
126(2)
15.3 Postoperative Complications
128(3)
15.3.1 Underdrainage
128(1)
15.3.2 Overdrainage
128(3)
15.4 Shunt Malfunction: Shunt Revisions
131(11)
15.4.1 When to Revise a Shunt?
131(1)
15.4.2 How to Revise a Shunt?
132(10)
16 Prognosis
142(4)
Ullrich Meier
16.1 Predictors
142(1)
16.2 Improvement of Prognosis
142(4)
17 Summary and Future Perspectives
146(3)
Michael J. Fritsch
17.1 Educating Medical Personnel
146(1)
17.2 Educating the Public
146(1)
17.3 Role of Biomarkers
147(1)
17.4 Diagnostic Tools and Prediction of Shunt Responsiveness
147(1)
17.5 Shunt Technology Improvement
147(2)
Index 149
Professor and Director, Department of Neurosurgery, Trauma Clinic Berlin-Marzahn
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