1.美国实践指南：特发性正常颅压脑积水对分流和预测因子的反应

制定者

美国神经病学学会（AAN）

内容介绍

ABSTRACT

Objective:Weevaluatedevidenceforutilityofshuntinginidiopathicnormalpressurehydrocephalus(iNPH)andforpredictorsofshuntingeffectiveness.

Methods:WeidentifiedandclassifiedrelevantpublishedstudiesaccordingtoandAmericanAcademyofNeurologymethodology.

Results:Of21articles,weidentified3ClassIarticles.

Conclusions:ShuntingispossiblyeffectiveiniNPH(96%chancesubjectiveimprovement,83%chanceimprovementontimedwalktestat6months)(3ClassIII).Seriousadverseeventriskwas11%(1ClassIII).PredictorsofsuccessincludedelevatedRo(1ClassI,multipleClassII),impairedcerebralbloodflowreactivitytoacetazolamide(bySPECT)(1ClassI),andpositiveresponsetoeitherexternallumbardrainage(1ClassIII)orrepeatedlumbarpunctures.Agemaynotbeaprognosticfactor(1ClassII).DataareinsufficienttojudgeefficacyofradionuclidecisternographyoraqueductalflowmeasurementbyMRI.

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