Factors Predicting Response to Shunting in Normal Pressure Hydrocephalus (NPH)
Normal Pressure Hydrocephalus
About this trial
This is an interventional diagnostic trial for Normal Pressure Hydrocephalus focused on measuring NPH, Normal Pressure Hydrocephalus
Eligibility Criteria
Inclusion Criteria:
- Walking difficulties in both legs which has developed gradually, not explained by other conditions, either in combination with mental impairment and urinary incontinence
- Brain CT or MRI findings of enlarged ventricles compared to established standards (minimum Evans ratio of 0.30 as measured by reviewing films)
- Mental impairment must be mild to moderate, emerging with or after the walking difficulties
- Age > or = 18 years old
- MMSE (Mini-mental status exam): < or = 10
- Urinary incontinence
Exclusion Criteria:
- No or only minimal walking difficulties combined with severe dementia
- Severe medical problems with limited life expectancy (less than six months)
- Contraindications to surgery
- Lack of informed consent
Sites / Locations
- University of California, Irvine - Medical Center
Arms of the Study
Arm 1
Experimental
Comparison for patients of lumbar drain and shunt surgery
Subjective comparisons made for patients - before and after external lumbar drain, before and after shunt surgery. Device: Programmable Shunt Insertion (Codman Medtronic) Behavioral: Assessments in physical therapy, occupational therapy, and speech therapy Follow-up testing to be administered by trained physician assistant in the outpatient setting on an approximately monthly basis: 10m walk, timed up-and-go, mini-mental status exam, 9-hole grooved pegboard, motor visual perception test (MVPT), modified rankin score (MRS)