Evidence map›Paper›PMID 41566497›Full record

ArticleFluids and barriers of the CNS2026

Assessment of patients affected by INPH after external lumbar drainage: what is the better timing?

Annalisa Marzi, Sara Maestrini, Cristina Schenone, Lucia Pellegrino, Davide Del Chiaro, Federica Collino, Mehrnaz Hamedani, Filippo Cotellessa, Paolo Missori, Antonio Currà and 9 more

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In one paragraph

Article in Fluids and barriers of the CNS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Annalisa MarziDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Sara MaestriniDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Cristina SchenoneDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy. crischenone92@gmail.com.
Lucia PellegrinoDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Davide Del ChiaroDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Federica CollinoDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Mehrnaz HamedaniDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Filippo CotellessaDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Paolo MissoriDepartment Neurology and Neurosurgery, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Antonio CurràDepartment Neurology and Neurosurgery, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Giuseppe RibizziIRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Marta PonzanoDepartment of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
Stefano CanevaIRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Matteo PardiniDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Paolo MerciadriIRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Pietro FiaschiDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Gianluigi ZonaDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Carlo TrompettoDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.
Laura MoriDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIdiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurological condition characterized by cerebrospinal fluid (CSF) accumulation contributing to clinical symptoms. Removal of excess CSF can lead to improvement, and among the available approaches, external lumbar drainage (ELD) offers superior diagnostic accuracy. However, the optimal timing for patient evaluation following ELD remains unclear.

methodsWe recruited 54 adult iNPH patients, assessed at baseline (T0), 48 hours (T1), and 10 days (T2) after ELD. Balance performance was measured using clinical scales for both static and dynamic balance, while gait parameters were instrumentally assessed at patient usual pace, both without and with concurrent cognitive dual task.

resultsClinical scales showed no significant change at T1, while a statistically significant improvement emerged at T2. Instrumental gait analysis revealed more robust changes at T2, involving a greater number of parameters and reaching stronger significance levels. Regarding potential ELD responders, more patients exceeded the Minimal Detectable Change thresholds for both clinical and instrumental measures at T2.

conclusionsAlthough current literature lacks clear guidance on timing, our findings suggest that extending follow-up to 10 days provides a more comprehensive and reliable assessment of potential improvements. These results should be validated in larger studies with additional follow-up to confirm the long-term predictive value of ELD for shunt surgery.

Indexed as

DrainageHydrocephalus, Normal PressurePostural BalanceAgedAged, 80 and overFemaleGaitHumansMaleMiddle AgedTime FactorsCerebrospinal fluidGait disorderHydrocephalusNormal pressureOutcome measuresPostural balance

Identifiers

PMID41566497
PMCPMC12908282

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Registered trials

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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.