Clinical Efficacy And Influencing Factors In The Treatment Of Normal Pressure Hydrocephalus

Objective:To investigate the clinical effect and related factors in the treatment of normal pressure hydrocephalus.Methods:According to the surgical method,82 patients with NPH who admitted to the Department of Neurosurgery at the Fifth Affiliated Hospital of Zhengzhou University,from March 2007 to May 2017,were retrospectively analyzed and divided into two groups: ETV group(n = 25)and V-P shunting group(n = 57),respectively.The therapeutic effect of ETV treatment was evaluated based on the postoperative clinical symptoms,imaging findings,complications,and etc.Results:In the ETV group,symptoms of headache,dizziness,and gait instability were significantly reduced in 12 patients;dementia symptoms were relieved in 5 patients;urinary incontinence symptoms were relieved in 3 patients;and no symptomatic remission was observed in 5 patients.Patients in the V-P group had different degrees of improvement in symptoms.The symptoms of headache,dizziness,and gait instability were significantly reduced in 31 patients;the dementia symptoms were relieved in 10 patients;the urinary incontinence symptoms were relieved in 9 patients,and the symptoms in 7 patients were not significantly improved.Conclusion:The treatment of normal pressure hydrocephalus(NPH)with neuroendoscopic third ventriculostomy(ETV)is a therapeutic method with good effect,small trauma,less postoperative complications and rapid postoperative recovery.The results of CSF release test(CSF-tt)can be used to predict the operative effect.but CSF-tt invalid is not equivalent to operation invalid.The surgical treatment of patients with interstitial brain edema is superior to that of patients without interstitial edema.The early detection,early diagnosis and early treatment of NPH patients are very important and directly related to the effect of surgical treatment.NPH patients with third anterior ventricle hernia and lower hernia have better surgical outcomes than NPH patients who have not combined with third ventricle hernia and lower hernia.