Status:

UNKNOWN

European Study on Prediction of Outcome in Patients With Idiopathic Normal Pressure Hydrocephalus

Lead Sponsor:

International Neuroscience Institute Hannover

Collaborating Sponsors:

Sahlgrenska University Hospital

Department of Neurology and Neurosurgery,Westeinde Hospital, Den Haag

Conditions:

Normal Pressure Hydrocephalus

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

The purpose of the study is to determine the predictive values and prognostic accuracies of CSF dynamic measures, the TAP -TEST (high-volume cerebrospinal fluid withdrawal), resistance to CSF outflow ...

Detailed Description

Study background: The selection of patients with idiopathic normal pressure hydrocephalus (INPH) for shunting remains difficult. The upcoming guidelines for the diagnosis and management of INPH state...

Eligibility Criteria

Inclusion

  • Clinical diagnosis (neurological and radiological criteria) of idiopathic normal pressure hydrocephalus
  • Typical INPH
  • Clinical criteria:
  • Gradually developed gait disturbance of both legs, unexplained by other conditions. Disturbance of tandem walking, multi-step turning, small steps and wide base must be present at least.
  • MMSE score 21-30 without aphasia, apraxia and agnosia
  • Bladder instability and postural instability may be present.
  • Radiological criteria (MRI):
  • Symmetrical communicating quadri-ventricular enlargement without cortical infarcts or other clinically relevant parenchymal lesions but lacunar infarcts of less than 1 cc may be present
  • Evans index \> 0.30 and temporal horns and third ventricle relatively enlarged.
  • Mild cortical atrophy and mild leuco-araiosis may be present.
  • Questionable NPH
  • Clinical criteria:
  • Any gait disturbance of both legs that does not fulfill the criteria of typical INPH, but is compatible with INPH.
  • MMSE score \< 21
  • Bladder instability and postural instability may be present.
  • Radiological criteria (MRI):
  • Symmetrical communicating quadri-ventricular enlargement without major parenchymal lesions. Single cortical infarcts and lacunar infarcts may be present.
  • Evans index \> 0.30.
  • Moderate cortical atrophy and moderate to severe leuco-araiosis may be present.

Exclusion

  • Secondary Normal pressure Hydrocephalus
  • Non-communicating hydrocephalus
  • Secondary NPH (after SAH, trauma, infection, neurosurgical procedure). Trauma or infection are regarded as relevant if the patient was unconscious in relation to the trauma or required hospitalisation for his meningo-encephalitis.
  • INPH-patients later shown to have ICP \> 18 mm Hg.
  • Contra-indications to surgery.
  • Patients refusing shunt surgery
  • Restricted life-expectancy
  • Patients not capable of managing the tests or investigations at entry of the study

Key Trial Info

Start Date :

October 1 2004

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

June 1 2009

Estimated Enrollment :

156 Patients enrolled

Trial Details

Trial ID

NCT00874198

Start Date

October 1 2004

End Date

June 1 2009

Last Update

April 3 2009

Active Locations (1)

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International Neuroscience Institute Hannover

Hanover, Lower Saxony, Germany, 30625