ArticleFluids and barriers of the CNS2019
The Kuopio idiopathic normal pressure hydrocephalus protocol: initial outcome of 175 patients.
Article in Fluids and barriers of the CNS, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Utility of cortical tissue analysis in normal pressure hydrocephalus.Cerebral cortex (New York, N.Y. : 1991) · 2024Pooled it
- A Randomized Trial of Shunting for Idiopathic Normal-Pressure Hydrocephalus.The New England journal of medicine · 2025Trial
- The performance of plasma pTau181 and pTau217 in distinguishing Alzheimer's disease from various neurodegenerative disorders, psychiatric disorders, and cognitively unimpaired controls.Journal of Alzheimer's disease : JAD · 2026Article
- Brain ventricle morphology markers in predicting shunt surgery outcome in idiopathic normal-pressure hydrocephalus.Fluids and barriers of the CNS · 2026Article
- Reduced risk of shunt revision with adjustable valves: a population-based cohort study over three decades.Acta neurochirurgica · 2026Article
- Value of biomarkers in the prediction of shunt responsivity in patients with normal pressure hydrocephalus.Neurosurgical review · 2025Observational
- Cerebrospinal fluid proteome profiling across the Alzheimer's disease continuum: a step towards solving the equation for 'X'.Molecular neurodegeneration · 2025Article
- Effect of ventricular volume on cerebrospinal fluid Alzheimer's disease biomarkers in patients with idiopathic normal pressure hydrocephalus.Journal of Alzheimer's disease : JAD · 2025Article
- Monoallelic TYROBP deletion is a novel risk factor for Alzheimer's disease.Molecular neurodegeneration · 2025Article
- The effectiveness of various CSF diversion surgeries in idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Deep learning assisted quantitative analysis of Aβ and microglia in patients with idiopathic normal pressure hydrocephalus in relation to cognitive outcome.Journal of neuropathology and experimental neurology · 2024Article
- Ventriculoperitoneal shunt patients and glaucoma: a cohort analysis of the NPH registry.Fluids and barriers of the CNS · 2024Article
- Article
- Early Alzheimer's disease pathology in human cortex is associated with a transient phase of distinct cell states.bioRxiv : the preprint server for biology · 2023Article
- Novel cerebrospinal fluid biomarkers correlating with shunt responsiveness in patients with idiopathic normal pressure hydrocephalus.Fluids and barriers of the CNS · 2023Article
- Comparison Between Ventricular and Spinal Infusion Tests in Suspected Normal Pressure Hydrocephalus.Acta neurochirurgica. Supplement · 2023Article
- Concordance of Alzheimer's Disease-Related Biomarkers Between Intraventricular and Lumbar Cerebrospinal Fluid in Idiopathic Normal Pressure Hydrocephalus.Journal of Alzheimer's disease : JAD · 2023Article
- The effect of shunt surgery on corticospinal excitability in idiopathic normal pressure hydrocephalus: a transcranial magnetic stimulation study.Fluids and barriers of the CNS · 2022Article
- In vivo assessment of Lewy body and beta-amyloid copathologies in idiopathic normal pressure hydrocephalus: prevalence and associations with clinical features and surgery outcome.Fluids and barriers of the CNS · 2022Article
- Motor skills, cognitive impairment, and quality of life in normal pressure hydrocephalus: early effects of shunt placement.Acta neurochirurgica · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Kuopio University Hospital (KUH) idiopathic normal pressure hydrocephalus (iNPH) cerebrospinal fluid (CSF) shunting protocol is described together with the initial outcomes of 175 patients with probable iNPH treated according to this protocol from a defined population. Our secondary aim was to display the variety of differential diagnoses referred to the KUH iNPH outpatient clinic from 2010 until 2017.
methodsPatients were divided into four groups according to the prognostic tests: tap test (positive or negative) and infusion test (positive or negative). The short-term outcome was compared between groups. The 3-month outcome following shunt surgery was assessed by measuring gait speed improvement, using a 12-point iNPH grading scale (iNPHGS) and the 15D instrument.
resultsFrom 341 patients suspected of iNPH, 88 patients were excluded from further research mostly due to deviation from the protocol's gait assessment guidelines. Hence 253 patients with suspected iNPH were included in the study, 177/253 (70%) of whom were treated with a CSF shunt. A favorable clinical outcome following surgery was observed in 79-93% of patients depending on the prognostic group. A moderate association (Cramer's V = 0.32) was found between the gait speed improvement rate and the prognostic group (X
conclusionsOur results emphasize the importance of a systematic diagnostic and prognostic workup especially in cases with an atypical presentation of iNPH. Additional diagnostic testing may be required, but should not delay adequate care. Active surgical treatment is recommended in patients with a high clinical probability of iNPH. Other neurological conditions contributed to most of the non iNPH diagnoses.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.