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Normal Pressure Hydrocephalus: Sensitivity and Specificity

Introduction: None written.

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Tags: Neurologic Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
people > 65 0.41% taken from a German town, confirmed by CT scan.

Arch Neurol. 1995 Oct;52(10):1017-22. PMID: 7575219

Patients shunted for presumed NPH 29% (i.e. percent responding to shunt)

J Neurol Neurosurg Psychiatry. 1993 Mar;56(3):251-6. PMID: 8459240

More, Edit...

The sensitivity and specificity of findings for Normal Pressure Hydrocephalus are listed below. See the left navigation bar to change the display.

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Finding SensitivitySpecificity Comments, Study
Clinical and CT Diagnosis Edit 54%84%

'probable' NPH by all of the following criteria:

  • Clinical: 1) Predominance of gait disturbances; 2) Mental impairment ranging from not clinically present to moderate; 3) Absence of another disease which might explain the clinical symptoms.
  • CT: 1) Rounded frontal horns; 2) At least moderate ventriculomegaly (FHi 0 40 or higher); 3) Absence of moderate or severe cortical atrophy, and 4) Absence of moderate or severe white matter lucencies.
  • Study: J Neurol Neurosurg Psychiatry. 1993 Mar;56(3):251-6. PMID: 8459240

    CSF Outflow Resistance Edit 58%44%

    Another (lower class) study reported sens 100%, spec 92%.

    Study: Neurosurgery. 2005 Sep;57(3 Suppl):S17-28. PMID: 16160426

    CSF Removal Edit 62%33%

    "tap test" - large-volume (>30 ml) removal of CSF by LP. 'Gold standard' was improvement after VP shunt placement.

    Study: Neurosurgery. 2005 Sep;57(3 Suppl):S17-28. PMID: 16160426

    External Lumbar Drainage Edit 50%80%

    this involves placing a catheter in the spine and draining CSF over a longer time period (say, 72 hrs).

    Another study reported sens = 97% , spec = 60%.

    Study: Neurosurgery. 2005 Sep;57(3 Suppl):S17-28. PMID: 16160426