TY - JOUR
T1 - Repeated Cerebrospinal Fluid Removal Procedure in Older Patients With Idiopathic Normal Pressure Hydrocephalus Ineligible for Surgical Treatment
AU - Rossi, Paolo Dionigi
AU - Damanti, Sarah
AU - Nani, Carolina
AU - Pluderi, Mauro
AU - Bertani, Giulio
AU - Mari, Daniela
AU - Cesari, Matteo
AU - Consonni, Dario
AU - Spagnoli, Diego
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Objectives: To evaluate the effects of repeated cerebrospinal fluid (CSF) tap procedures in idiopathic normal pressure hydrocephalus (iNPH) patients ineligible for surgical treatment. Design: Prospective, monocentric, pilot study. Setting: University hospital. Participants: Thirty-nine patients aged 75 years and older, ineligible for shunting surgical intervention. Intervention: Repeated CSF taps. Measurements: All patients underwent a comprehensive geriatric assessment before and after each CSF tap. Adverse events were recorded. Results: No major side effect was reported. Eleven patients showed no response to the first CSF tap test and were excluded. In the remaining 28 patients, all physical and cognitive functions improved after the drainage procedures, except for continence (which seemed poorly influenced). According to clinical judgment, the mean time frame of benefit between CSF taps was 7 months. Patients withdrawing from the protocol during the clinical follow-up showed a worsening of functional and cognitive performances after the interruption. Conclusions/Implications: Periodic CSF therapeutic taps are safe, allow a better control of iNPH symptoms, and prevent functional decline in geriatric patients.
AB - Objectives: To evaluate the effects of repeated cerebrospinal fluid (CSF) tap procedures in idiopathic normal pressure hydrocephalus (iNPH) patients ineligible for surgical treatment. Design: Prospective, monocentric, pilot study. Setting: University hospital. Participants: Thirty-nine patients aged 75 years and older, ineligible for shunting surgical intervention. Intervention: Repeated CSF taps. Measurements: All patients underwent a comprehensive geriatric assessment before and after each CSF tap. Adverse events were recorded. Results: No major side effect was reported. Eleven patients showed no response to the first CSF tap test and were excluded. In the remaining 28 patients, all physical and cognitive functions improved after the drainage procedures, except for continence (which seemed poorly influenced). According to clinical judgment, the mean time frame of benefit between CSF taps was 7 months. Patients withdrawing from the protocol during the clinical follow-up showed a worsening of functional and cognitive performances after the interruption. Conclusions/Implications: Periodic CSF therapeutic taps are safe, allow a better control of iNPH symptoms, and prevent functional decline in geriatric patients.
KW - elderly
KW - Idiopathic normal pressure hydrocephalus
KW - lumbar puncture
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U2 - 10.1016/j.jamda.2018.11.014
DO - 10.1016/j.jamda.2018.11.014
M3 - Article
C2 - 30638833
AN - SCOPUS:85059646230
VL - 20
SP - 373-376.e3
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
SN - 1525-8610
IS - 3
ER -