Time Course of Symptoms in Normal-Pressure Hydrocephalus: A Systematic Review
Loading...
Date
Publisher
MDPI
Abstract
Background and Objectives: Idiopathic normal-pressure hydrocephalus (NPH) is a treatable,
but diagnostically challenging condition in the elderly marked by gait disturbance,
cognitive decline, and urinary incontinence. Ventriculoperitoneal (VP) shunting is effective,
but the prognostic significance of symptom duration before surgery remains unclear.
This systematic review evaluates symptom duration in NPH patients with postoperative
outcomes. Methods: A systematic search of PubMed, Scopus, and Embase was conducted
per PRISMA guidelines. Studies were included if they assessed clinical or radiological
outcomes of VP shunting in adult NPH patients, reported symptom duration, and had
a follow-up of at least one month. Clinical outcomes (MMSE, TUG, NPH score) were
qualitatively analyzed due to study heterogeneity. Results: Twenty-four studies comprising
1169 patients were included (mean age: 72.45 years; mean symptom duration:
33.04 months). Most studies reported clinical improvement after VP shunting. However,
few directly evaluated the effect of symptom duration, yielding inconsistent findings: some
suggested better outcomes with shorter symptom duration, while others found no clear
correlation. Larger studies often lacked conclusive data, and no randomized controlled
trials were identified. Conclusions: VP shunting remains an effective intervention for
NPH; however, evidence supporting the predictive value of preoperative symptom length
is inconclusive. This review highlights the need for standardized diagnostic protocols and
larger prospective studies to clarify this association and optimize surgical timing.
Metadata
License
Except where otherwised noted, this item's license is described as Attribution 4.0 International