{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T18:39:54Z","timestamp":1755801594723,"version":"3.44.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T00:00:00Z","timestamp":1538006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Constant infusion lumbar infusion test (<jats:styled-content style=\"fixed-case\">LIT<\/jats:styled-content>) is an important way to find which patients, of those with signs and symptoms corresponding to normal pressure hydrocephalus (<jats:styled-content style=\"fixed-case\">NPH<\/jats:styled-content>) who will improve from shunt operation.<jats:styled-content style=\"fixed-case\">LIT<\/jats:styled-content>is a stress test on the ability for cerebrospinal fluid re\u2010absorbtion. The aim of this study is to show how the information from<jats:styled-content style=\"fixed-case\">LIT<\/jats:styled-content>can be improved by quantitative analysis and avoidance of methodological pitfalls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The potential pitfalls, and the analysis method, are described in detail. The analysis was applied on pre\u2010operative constant infusion<jats:styled-content style=\"fixed-case\">LIT<\/jats:styled-content>from 31 patients operated for<jats:styled-content style=\"fixed-case\">NPH<\/jats:styled-content>, with known outcome. The pre\u2010 and post\u2010operative walking speed was used to grade pathology progression or improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The maximal, plateau, intra\u2010spinal pressure at constant infusion<jats:styled-content style=\"fixed-case\">LIT<\/jats:styled-content>is an ambivalent indicator for<jats:styled-content style=\"fixed-case\">NPH<\/jats:styled-content>: while low maximal pressure indicates no cerebrospinal fluid (<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>) absorbtion pathology, too high pressure (\u226547\u00a0mmHg) may mean no diagnosis, because of stenosis of the Sylvian aqueduct. When subjects with too high intra\u2010spinal pressure were excluded, the new analysis gave a couple of diagnostic volume parameters, of which one appears to be an optimal<jats:styled-content style=\"fixed-case\">LIT<\/jats:styled-content>parameter for identifying<jats:styled-content style=\"fixed-case\">NPH<\/jats:styled-content>patients with 14% better accuracy than plateau pressure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>By avoiding methodological pitfalls, and optimal analysis of the results from lumbar infusion test, the number of<jats:styled-content style=\"fixed-case\">NPH<\/jats:styled-content>patients who do not have a successful outcome after shunt operation may be further decreased.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.1125","type":"journal-article","created":{"date-parts":[[2018,9,27]],"date-time":"2018-09-27T03:05:46Z","timestamp":1538017546000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Improved lumbar infusion test analysis for normal pressure hydrocephalus diagnosis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-338X","authenticated-orcid":false,"given":"Erik","family":"Ryding","sequence":"first","affiliation":[{"name":"Department of Clinical Neurophysiology Skane University Hospital Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Babar","family":"Kahlon","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery King Feisal Hospital Riad Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Reinstrup","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Skane University Hospital Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.42.8.687"},{"key":"e_1_2_7_3_1","first-page":"331","article-title":"Does CSF outflow resistance predict the response to shunting in patients with normal pressure hydrocephalus?","volume":"71","author":"Boon A. 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