1.美国实践指南：特发性正常颅压脑积水对分流和预测因子的反应
制定者
美国神经病学学会（AAN）
内容介绍
ABSTRACT
Objective:Weevaluatedevidenceforutilityofshuntinginidiopathicnormalpressurehydrocephalus(iNPH)andforpredictorsofshuntingeffectiveness.
Methods:WeidentifiedandclassifiedrelevantpublishedstudiesaccordingtoandAmericanAcademyofNeurologymethodology.
Results:Of21articles,weidentified3ClassIarticles.
Conclusions:ShuntingispossiblyeffectiveiniNPH(96%chancesubjectiveimprovement,83%chanceimprovementontimedwalktestat6months)(3ClassIII).Seriousadverseeventriskwas11%(1ClassIII).PredictorsofsuccessincludedelevatedRo(1ClassI,multipleClassII),impairedcerebralbloodflowreactivitytoacetazolamide(bySPECT)(1ClassI),andpositiveresponsetoeitherexternallumbardrainage(1ClassIII)orrepeatedlumbarpunctures.Agemaynotbeaprognosticfactor(1ClassII).DataareinsufficienttojudgeefficacyofradionuclidecisternographyoraqueductalflowmeasurementbyMRI.
