Who is the ideal candidate for shunt surgery for the treatment of normal pressure hydrocephalus (NPH)?

Updated: Oct 19, 2018
  • Author: Michael J Schneck, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

In summary, an ideal candidate for shunt surgery would show imaging evidence of ventriculomegaly indicated by a frontal horn ratio exceeding 0.50 on imaging studies along with one or more of the following criteria:

  • Presence of a clearly identified etiology

  • Predominant gait difficulties with mild or absent cognitive impairment

  • Substantial improvement after CSF withdrawal (CSF tap test or lumbar drainage)

  • Normal-sized or occluded sylvian fissures and cortical sulci on CT or MRI

  • Absent or moderate white matter lesions on MRI


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