Evidence map›Paper›PMID 42128964›Full record

ArticleActa neurochirurgica2026

Idiopathic normal pressure hydrocephalus: validation of the DESH score in the Capital Region of Denmark.

Bjarni Johannsson, Jan Saip Aunan-Diop, Jonathan Frederik Carlsen, Anika Mai Johannsdottir, Sune Munthe, Frantz Rom Poulsen, Mathias Just Nortvig, Steen Hasselbach, Tina Nørgaard Munch, Christian Bonde Pedersen

Abstract readValidation Study
In one paragraph

Article in Acta neurochirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

10 authors.

Bjarni JohannssonDepartment of Neurosurgery, Odense University Hospital, Odense, Fyn, 5000, Denmark. bjarni.johannsson@rsyd.dk.
Jan Saip Aunan-DiopDepartment of Neurosurgery, Odense University Hospital, Odense, Fyn, 5000, Denmark.
Jonathan Frederik CarlsenDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Capital Region, 2100, Denmark.
Anika Mai JohannsdottirDepartment of Neurosurgery, Odense University Hospital, Odense, Fyn, 5000, Denmark.
Sune MuntheDepartment of Neurosurgery, Odense University Hospital, Odense, Fyn, 5000, Denmark.
Frantz Rom PoulsenDepartment of Neurosurgery, Odense University Hospital, Odense, Fyn, 5000, Denmark.
Mathias Just NortvigDepartment of Neurosurgery, Odense University Hospital, Odense, Fyn, 5000, Denmark.
Steen HasselbachDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Capital Region, 2100, Denmark.
Tina Nørgaard MunchDepartment of Neurosurgery, Copenhagen University Hospital, Copenhagen, Capital Region, 2100, Denmark.
Christian Bonde PedersenDepartment of Neurosurgery, Odense University Hospital, Odense, Fyn, 5000, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePrevious research has shown that the Disproportionally Enlarged Subarachnoid-space Hydrocephalus (DESH) score may be a prognostic factor for shunt surgery response for idiopathic normal pressure hydrocephalus (iNPH) patients at 1-month follow-up after shunt surgery. The objective of the current study was external validation in an independent cohort with a longer follow-up period. Secondarily, to assess whether the grading system was confounded by imaging modality.

methodsPreoperative baseline characteristics, magnetic resonance imaging (MRI) and/or computed tomography (CT) scans were retrospectively obtained in 127 shunt-operated iNPH patients. Evans' index, dilation of Sylvian fissures, tight high convexity, focal sulci, callosal angle, and a combination of these radiologic findings (DESH score) were compared according to patients' response to shunt treatment at a mean follow-up period of 7.4-months. In addition, the data were adjusted for whether grading was performed by MRI or CT.

resultsMultivariate logistic regression, adjusted for age, sex, and imaging modality, demonstrated a significant association between the DESH score and objective shunt response at follow-up (Odds Ratio 1.35, p = 0.036). Bivariate logistic regression revealed no significant difference in DESH score assessments between CT and MRI. Moreover, including or excluding imaging modality in the multivariate model did not meaningfully alter the regression coefficients.

conclusionConsistent with and supportive of prior findings, the DESH score is associated with shunt response in iNPH patients. No evidence of confounding by imaging modality was identified in this cohort. However, formal equivalence between CT and MRI for DESH scoring remains to be established in studies with paired imaging.

Indexed as

Hydrocephalus, Normal PressureSubarachnoid SpaceAgedAged, 80 and overCerebrospinal Fluid ShuntsDenmarkFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesSeverity of Illness IndexTomography, X-Ray ComputedAdult hydrocephalusDiagnosticsNormal pressure hydrocephalusShunt surgery

Identifiers

PMID42128964
PMCPMC13341902

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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.