{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:40:04Z","timestamp":1793468404907,"version":"4.5.0"},"reference-count":65,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2022,11,26]],"date-time":"2022-11-26T00:00:00Z","timestamp":1669420800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,26]],"date-time":"2022-11-26T00:00:00Z","timestamp":1669420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurochir"],"abstract":"<jats:title>Abstract\n<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with the dementia subtype idiopathic normal pressure hydrocephalus (iNPH) may improve clinically following cerebrospinal fluid (CSF) diversion (shunt) surgery, though the predictors of shunt response remain debated. Currently, radiological features play an important role in the diagnosis of iNPH, but it is not well established which radiological markers most precisely predict shunt responsive iNPH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To conduct a systematic review and meta-analysis to identify radiological predictors of shunt responsiveness, evaluate their diagnostic effectiveness, and recommend the most predictive radiological features.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Embase, MEDLINE, Scopus, PubMed, Google Scholar, and JSTOR were searched for original studies investigating radiological predictors of shunt response in iNPH patients. Included studies were assessed using the ROBINS-1 tool, and eligible studies were evaluated using a univariate meta-analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 301 full-text papers were screened, of which 28 studies were included, and 26 different radiological features were identified, 5 of these met the inclusion criteria for the meta-analysis: disproportionately enlarged subarachnoid space (DESH), callosal angle, periventricular white matter changes, cerebral blood flow (CBF), and computerized tomography cisternography. The meta-analysis showed that only callosal angle and periventricular white matter changes significantly differentiated iNPH shunt responders from non-responders, though both markers had a low diagnostic odds ratio (DOR) of 1.88 and 1.01 respectively. None of the other radiological markers differentiated shunt responsive from shunt non-responsive iNPH.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Callosal angle and periventricular changes are the only diagnostically effective radiological predictors of shunt responsive iNPH patients. However, due to the DORs approximating 1, they are insufficient as sole predictors and are advised to be used only in combination with other diagnostic tests of shunt response. Future research must evaluate the combined use of multiple radiological predictors, as it may yield beneficial additive effects that may allow for more robust radiological shunt response prediction.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-022-05402-8","type":"journal-article","created":{"date-parts":[[2022,11,27]],"date-time":"2022-11-27T01:30:53Z","timestamp":1669512653000},"page":"369-419","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Radiological predictors of shunt response in the diagnosis and treatment of idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"165","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9274-0350","authenticated-orcid":false,"given":"Santhosh G.","family":"Thavarajasingam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"El-Khatib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalyan","family":"Vemulapalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector A. Sinzinkayo","family":"Iradukunda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajeenth Vishnu","family":"K.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Borchert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per K.","family":"Eide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,26]]},"reference":[{"key":"5402_CR1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1056\/NEJM196507152730301","volume":"273","author":"RD Adams","year":"1965","unstructured":"Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH (1965) Symptomatic occult hydrocephalus with \u201cnormal\u201d cerebrospinal-fluid pressure. A treatable syndrome. N Engl J Med 273:117\u2013126. https:\/\/doi.org\/10.1056\/NEJM196507152730301","journal-title":"N Engl J Med"},{"key":"5402_CR2","doi-asserted-by":"publisher","first-page":"74","DOI":"10.3174\/ajnr.A5910","volume":"40","author":"S Agerskov","year":"2019","unstructured":"Agerskov S, Wallin M, Hellstrom P, Ziegelitz D, Wikkelso C, Tullberg M (2019) Absence of disproportionately enlarged subarachnoid space hydrocephalus, a sharp callosal angle, or other morphologic mri markers should not be used to exclude patients with idiopathic normal pressure hydrocephalus from shunt surgery. AJNR Am J Neuroradiol 40:74\u201379. https:\/\/doi.org\/10.3174\/ajnr.A5910","journal-title":"AJNR Am J Neuroradiol"},{"key":"5402_CR3","doi-asserted-by":"publisher","first-page":"e0240327","DOI":"10.1371\/journal.pone.0240327","volume":"15","author":"S Agerskov","year":"2020","unstructured":"Agerskov S, Arvidsson J, Ziegelitz D, Lagerstrand K, Starck G, Bjorkman-Burtscher IM, Wikkelso C, Tullberg M (2020) MRI diffusion and perfusion alterations in the mesencephalon and pons as markers of disease and symptom reversibility in idiopathic normal pressure hydrocephalus. PLoS ONE 15:e0240327. https:\/\/doi.org\/10.1371\/journal.pone.0240327","journal-title":"PLoS ONE"},{"key":"5402_CR4","doi-asserted-by":"publisher","first-page":"13054","DOI":"10.1038\/s41598-020-70035-9","volume":"10","author":"Y Aoki","year":"2020","unstructured":"Aoki Y, Kazui H, Bruna R, Pascual-Marqui RD, Yoshiyama K, Wada T, Kanemoto H, Suzuki Y, Suehiro T, Matsumoto T, Kakeda K, Hata M, Canuet L, Ishii R, Iwase M, Ikeda M (2020) Normalized power variance of eLORETA at high-convexity area predicts shunt response in idiopathic normal pressure hydrocephalus. Sci Rep 10:13054. https:\/\/doi.org\/10.1038\/s41598-020-70035-9","journal-title":"Sci Rep"},{"key":"5402_CR5","doi-asserted-by":"publisher","first-page":"371","DOI":"10.3171\/jns.1980.52.3.0371","volume":"52","author":"PM Black","year":"1980","unstructured":"Black PM (1980) Idiopathic normal-pressure hydrocephalus. Results of shunting in 62 patients. J Neurosurg 52:371\u2013377. https:\/\/doi.org\/10.3171\/jns.1980.52.3.0371","journal-title":"J Neurosurg"},{"key":"5402_CR6","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.ejrad.2017.07.013","volume":"95","author":"MK Brix","year":"2017","unstructured":"Brix MK, Westman E, Simmons A et al (2017) The Evans\u2019 index revisited: new cutoff levels for use in radiological assessment of ventricular enlargement in the elderly. Eur J Radiol 95:28\u201332. https:\/\/doi.org\/10.1016\/j.ejrad.2017.07.013","journal-title":"Eur J Radiol"},{"issue":"4","key":"5402_CR7","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.3233\/JAD-150107","volume":"46","author":"A Cagnin","year":"2015","unstructured":"Cagnin A, Simioni M, Tagliapietra M, Citton V, Pompanin S, Della Puppa A, Ermani M, Manara R (2015) A simplified callosal angle measure best differentiates idiopathic-normal pressure hydrocephalus from neurodegenerative dementia. J Alzheimers Dis 46(4):1033\u20131038. https:\/\/doi.org\/10.3233\/JAD-150107 (PMID: 26402630)","journal-title":"J Alzheimers Dis"},{"issue":"1","key":"5402_CR8","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.surneu.2008.08.079","volume":"70","author":"YF Chen","year":"2008","unstructured":"Chen YF, Wang YH, Hsiao JK, Lai DM, Liao CC, Tu YK, Liu HM (2008) Normal pressure hydrocephalus: cerebral hemodynamic, metabolism measurement, discharge score, and long-term outcome. Surg Neurol 70(1):69\u201377. https:\/\/doi.org\/10.1016\/j.surneu.2008.08.079","journal-title":"Surg Neurol"},{"key":"5402_CR9","unstructured":"Covidence (2020) Covidence - Better systematic review man-agement. Accessed October 1 2021"},{"key":"5402_CR10","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1227\/01.NEU.0000363408.69856.B8","volume":"66","author":"PK Eide","year":"2010","unstructured":"Eide PK, Sorteberg W (2010) Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients. Neurosurgery 66:80\u201391. https:\/\/doi.org\/10.1227\/01.NEU.0000363408.69856.B8","journal-title":"Neurosurgery"},{"key":"5402_CR11","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s00701-021-05050-4","volume":"164","author":"PK Eide","year":"2022","unstructured":"Eide PK, Sorteberg W (2022) Invasive tests for predicting shunt response in idiopathic normal pressure hydrocephalus: the risk aspect. Acta Neurochir (Wien) 164:481\u2013482. https:\/\/doi.org\/10.1007\/s00701-021-05050-4","journal-title":"Acta Neurochir (Wien)"},{"issue":"9","key":"5402_CR12","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.1212\/wnl.43.9.1683","volume":"43","author":"F Fazekas","year":"1993","unstructured":"Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F, Radner H, Lechner H (1993) Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology 43(9):1683\u20131689. https:\/\/doi.org\/10.1212\/wnl.43.9.1683 (PMID: 8414012)","journal-title":"Neurology"},{"key":"5402_CR13","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1177\/096228029300200202","volume":"2","author":"JL Fleiss","year":"1993","unstructured":"Fleiss JL (1993) The statistical basis of meta-analysis. Stat Methods Med Res 2:121\u2013145. https:\/\/doi.org\/10.1177\/096228029300200202","journal-title":"Stat Methods Med Res"},{"key":"5402_CR14","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1007\/s00701-016-2858-5","volume":"158","author":"R Garcia-Armengol","year":"2016","unstructured":"Garcia-Armengol R, Domenech S, Botella-Campos C, Goncalves FJ, Menendez B, Teixidor P, Munoz-Narbona L, Rimbau J (2016) Comparison of elevated intracranial pressure pulse amplitude and disproportionately enlarged subarachnoid space (DESH) for prediction of surgical results in suspected idiopathic normal pressure hydrocephalus. Acta Neurochir (Wien) 158:2207\u20132213. https:\/\/doi.org\/10.1007\/s00701-016-2858-5","journal-title":"Acta Neurochir (Wien)"},{"key":"5402_CR15","doi-asserted-by":"publisher","unstructured":"Giordan E, Palandri G, Lanzino G, Murad MH, Elder BD (2018) Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. J Neurosurg 1\u201313.https:\/\/doi.org\/10.3171\/2018.5.Jns1875","DOI":"10.3171\/2018.5.Jns1875"},{"key":"5402_CR16","doi-asserted-by":"publisher","first-page":"e717","DOI":"10.1016\/j.wneu.2018.04.150","volume":"115","author":"K Grahnke","year":"2018","unstructured":"Grahnke K, Jusue-Torres I, Szujewski C, Joyce C, Schneck M, Prabhu VC, Anderson DE (2018) The quest for predicting sustained shunt response in normal-pressure hydrocephalus: an analysis of the callosal angle\u2019s utility. World Neurosurgery 115:e717\u2013e722","journal-title":"World Neurosurgery"},{"key":"5402_CR17","unstructured":"G. S (2020) Package \u2018meta\u2019. The comprehensive R archive network. Accessed September 7 2021"},{"key":"5402_CR18","doi-asserted-by":"publisher","first-page":"3875","DOI":"10.1002\/sim.1009","volume":"20","author":"J Hartung","year":"2001","unstructured":"Hartung J, Knapp G (2001) A refined method for the meta-analysis of controlled clinical trials with binary outcome. Stat Med 20:3875\u20133889. https:\/\/doi.org\/10.1002\/sim.1009","journal-title":"Stat Med"},{"key":"5402_CR19","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1097\/00006123-200111000-00028","volume":"49","author":"AO Hebb","year":"2001","unstructured":"Hebb AO, Cusimano MD (2001) Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. Neurosurgery 49:1166\u20131184. https:\/\/doi.org\/10.1097\/00006123-200111000-00028","journal-title":"Neurosurgery"},{"key":"5402_CR20","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jns.2018.01.017","volume":"387","author":"YJ Hong","year":"2018","unstructured":"Hong YJ, Kim MJ, Jeong E, Kim JE, Hwang J, Lee JI, Lee JH, Na DL (2018) Preoperative biomarkers in patients with idiopathic normal pressure hydrocephalus showing a favorable shunt surgery outcome. J Neurol Sci 387:21\u201326. https:\/\/doi.org\/10.1016\/j.jns.2018.01.017","journal-title":"J Neurol Sci"},{"key":"5402_CR21","unstructured":"Howick J, Chalmers I, Glaziou P, Greenhalgh T, Heneghan C, Lib-erati A, Moschetti I, Phillips B, Thornton H, Goddard O, Hodgkinson M (2011) Explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Level of Evidence (Background Document). Oxford Centre for Evidence-Based Medicine. http:\/\/www.cebm.net\/index.aspx?o=5653. Accessed 7 Sept 2021"},{"key":"5402_CR22","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1176\/jnp.11.3.297","volume":"11","author":"RA Hurley","year":"1999","unstructured":"Hurley RA, Bradley WG Jr, Latifi HT, Taber KH (1999) Normal pressure hydrocephalus: significance of MRI in a potentially treatable dementia. J Neuropsychiatry Clin Neurosci 11:297\u2013300. https:\/\/doi.org\/10.1176\/jnp.11.3.297","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"5402_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000328972","volume":"32","author":"K Ishii","year":"2011","unstructured":"Ishii K, Hashimoto M, Hayashida K, Hashikawa K, Chang CC, Nakagawara J, Nakayama T, Mori S, Sakakibara R (2011) A multicenter brain perfusion SPECT study evaluating idiopathic normal-pressure hydrocephalus on neurological improvement. Dement Geriatr Cogn Disord 32:1\u201310. https:\/\/doi.org\/10.1159\/000328972","journal-title":"Dement Geriatr Cogn Disord"},{"key":"5402_CR24","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/978-3-319-22533-3_57","volume":"122","author":"M Ishikawa","year":"2016","unstructured":"Ishikawa M, Oowaki H, Takezawa M, Takenaka T, Yamada S, Yamamoto K, Okamoto S (2016) disproportionately enlarged subarachnoid space hydrocephalus in idiopathic normal-pressure hydrocephalus and its implication in pathogenesis. Acta Neurochir Suppl 122:287\u2013290. https:\/\/doi.org\/10.1007\/978-3-319-22533-3_57","journal-title":"Acta Neurochir Suppl"},{"key":"5402_CR25","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s00234-013-1289-8","volume":"56","author":"A Jurcoane","year":"2014","unstructured":"Jurcoane A, Keil F, Szelenyi A, Pfeilschifter W, Singer OC, Hattingen E (2014) Directional diffusion of corticospinal tract supports therapy decisions in idiopathic normal-pressure hydrocephalus. Neuroradiology 56:5\u201313. https:\/\/doi.org\/10.1007\/s00234-013-1289-8","journal-title":"Neuroradiology"},{"key":"5402_CR26","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.1007\/s00701-011-1047-9","volume":"153","author":"T Kawaguchi","year":"2011","unstructured":"Kawaguchi T, Hirata Y, Bundo M, Kondo T, Owaki H, Ito S, Hashimoto M, Ishikawa M (2011) Role of computerized tomographic cisternography in idiopathic normal pressure hydrocephalus. Acta Neurochir (Wien) 153:2041\u20132048. https:\/\/doi.org\/10.1007\/s00701-011-1047-9","journal-title":"Acta Neurochir (Wien)"},{"key":"5402_CR27","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jns.2013.02.020","volume":"328","author":"H Kazui","year":"2013","unstructured":"Kazui H, Mori E, Ohkawa S, Okada T, Kondo T, Sakakibara R, Ueki O, Nishio Y, Ishii K, Kawaguchi T, Ishikawa M, Takeda M (2013) Predictors of the disappearance of triad symptoms in patients with idiopathic normal pressure hydrocephalus after shunt surgery. J Neurol Sci 328:64\u201369. https:\/\/doi.org\/10.1016\/j.jns.2013.02.020","journal-title":"J Neurol Sci"},{"key":"5402_CR28","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1111\/ene.13555","volume":"25","author":"K Kockum","year":"2018","unstructured":"Kockum K, Lilja-Lund O, Larsson EM, Rosell M, Soderstrom L, Virhammar J, Laurell K (2018) The idiopathic normal-pressure hydrocephalus radscale: a radiological scale for structured evaluation. Eur J Neurol 25:569\u2013576. https:\/\/doi.org\/10.1111\/ene.13555","journal-title":"Eur J Neurol"},{"key":"5402_CR29","doi-asserted-by":"publisher","first-page":"e0232275","DOI":"10.1371\/journal.pone.0232275","volume":"15","author":"K Kockum","year":"2020","unstructured":"Kockum K, Virhammar J, Riklund K, S\u00f6derstr\u00f6m L, Larsson EM, Laurell K (2020) Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus. PLoS ONE 15:e0232275. https:\/\/doi.org\/10.1371\/journal.pone.0232275","journal-title":"PLoS ONE"},{"key":"5402_CR30","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1097\/00006123-199608000-00011","volume":"39","author":"JK Krauss","year":"1996","unstructured":"Krauss JK, Droste DW, Vach W, Regel JP, Orszagh M, Borremans JJ, Tietz A, Seeger W (1996) Cerebrospinal fluid shunting in idiopathic normal-pressure hydrocephalus of the elderly: effect of periventricular and deep white matter lesions. Neurosurgery 39:292\u2013299. https:\/\/doi.org\/10.1097\/00006123-199608000-00011","journal-title":"Neurosurgery"},{"key":"5402_CR31","doi-asserted-by":"publisher","first-page":"E747","DOI":"10.1093\/neuros\/nyz121","volume":"85","author":"G Kuchcinski","year":"2019","unstructured":"Kuchcinski G, Jacquiez C, Baroncini M, Machuron F, Behal H, Dumont J, Lopes R, Delmaire C, Lebouvier T, Bottlaender M, Bordet R, Defebvre L, Pruvo JP, Leclerc X, Hodel J (2019) Idiopathic normal-pressure hydrocephalus: diagnostic accuracy of automated sulcal morphometry in patients with ventriculomegaly. Neurosurgery 85:E747\u2013E755. https:\/\/doi.org\/10.1093\/neuros\/nyz121","journal-title":"Neurosurgery"},{"key":"5402_CR32","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1148\/96.2.347","volume":"96","author":"M LeMay","year":"1970","unstructured":"LeMay M, New PF (1970) Radiological diagnosis of occult normal-pressure hydrocephalus. Radiology 96:347\u2013358. https:\/\/doi.org\/10.1148\/96.2.347","journal-title":"Radiology"},{"key":"5402_CR33","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1007\/s00701-020-04699-7","volume":"163","author":"P Mantovani","year":"2021","unstructured":"Mantovani P, Giannini G, Milletti D, Cevoli S, Sturiale C, Valsecchi N, Gramegna LL, Albini-Riccioli L, Cortelli P, Lanzino G, Elder BD, Palandri G, Group P-HS (2021) Anterior callosal angle correlates with gait impairment and fall risk in iNPH patients. Acta Neurochir (Wien) 163:759\u2013766. https:\/\/doi.org\/10.1007\/s00701-020-04699-7","journal-title":"Acta Neurochir (Wien)"},{"key":"5402_CR34","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1093\/neurosurgery\/57.4.699","volume":"57","author":"MJ McGirt","year":"2005","unstructured":"McGirt MJ, Woodworth G, Coon AL, Thomas G, Williams MA, Rigamonti D (2005) Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus. Neurosurgery 57:699\u2013705. https:\/\/doi.org\/10.1093\/neurosurgery\/57.4.699","journal-title":"Neurosurgery"},{"key":"5402_CR35","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/s0967-5868(03)00079-1","volume":"10","author":"U Meier","year":"2003","unstructured":"Meier U, Miethke C (2003) Predictors of outcome in patients with normal-pressure hydrocephalus. J Clin Neurosci 10:453\u2013459. https:\/\/doi.org\/10.1016\/s0967-5868(03)00079-1","journal-title":"J Clin Neurosci"},{"key":"5402_CR36","doi-asserted-by":"publisher","first-page":"10473","DOI":"10.1038\/s41598-021-89848-3","volume":"11","author":"Z Merali","year":"2021","unstructured":"Merali Z, Wang JZ, Badhiwala JH, Witiw CD, Wilson JR, Fehlings MG (2021) A deep learning model for detection of cervical spinal cord compression in MRI scans. Sci Rep 11:10473. https:\/\/doi.org\/10.1038\/s41598-021-89848-3","journal-title":"Sci Rep"},{"key":"5402_CR37","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","volume":"6","author":"D Moher","year":"2009","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https:\/\/doi.org\/10.1371\/journal.pmed.1000097","journal-title":"PLoS Med"},{"key":"5402_CR38","doi-asserted-by":"publisher","first-page":"970","DOI":"10.3171\/jns.2001.95.6.0970","volume":"95","author":"K Mori","year":"2001","unstructured":"Mori K (2001) Management of idiopathic normal-pressure hydrocephalus: a multi-institutional study conducted in Japan. J Neurosurg 95:970\u2013973. https:\/\/doi.org\/10.3171\/jns.2001.95.6.0970","journal-title":"J Neurosurg"},{"key":"5402_CR39","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1007\/s00701-007-1259-1","volume":"149","author":"M Murakami","year":"2007","unstructured":"Murakami M, Hirata Y, Kuratsu JI (2007) Predictive assessment of shunt effectiveness in patients with idiopathic normal pressure hydrocephalus by determining regional cerebral blood flow on 3D stereotactic surface projections. Acta Neurochir (Wien) 149:991\u2013997. https:\/\/doi.org\/10.1007\/s00701-007-1259-1","journal-title":"Acta Neurochir (Wien)"},{"key":"5402_CR40","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2176\/nmc.st.2020-0292","volume":"61","author":"M Nakajima","year":"2021","unstructured":"Nakajima M, Yamada S, Miyajima M, Ishii K, Kuriyama N, Kazui H, Kanemoto H, Suehiro T, Yoshiyama K, Kameda M, Kajimoto Y, Mase M, Murai H, Kita D, Kimura T, Samejima N, Tokuda T, Kaijima M, Akiba C, Kawamura K, Atsuchi M, Hirata Y, Matsumae M, Sasaki M, Yamashita F, Aoki S, Irie R, Miyake H, Kato T, Mori E, Ishikawa M, Date I, Arai H, research committee of idiopathic normal pressure h, (2021) Guidelines for management of idiopathic normal pressure hydrocephalus (third edition): endorsed by the Japanese society of normal pressure hydrocephalus. Neurol Med Chir (Tokyo) 61:63\u201397. https:\/\/doi.org\/10.2176\/nmc.st.2020-0292","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"5402_CR41","doi-asserted-by":"publisher","first-page":"1831","DOI":"10.3174\/ajnr.A4838","volume":"37","author":"W Narita","year":"2016","unstructured":"Narita W, Nishio Y, Baba T, Iizuka O, Ishihara T, Matsuda M, Iwasaki M, Tominaga T, Mori E (2016) High-convexity tightness predicts the shunt response in idiopathic normal pressure hydrocephalus. AJNR Am J Neuroradiol 37:1831\u20131837. https:\/\/doi.org\/10.3174\/ajnr.A4838","journal-title":"AJNR Am J Neuroradiol"},{"key":"5402_CR42","first-page":"76","volume":"27","author":"WM Palm","year":"2006","unstructured":"Palm WM, Walchenbach R, Bruinsma B, Admiraal-Behloul F, Middelkoop HA, Launer LJ, van der Grond J, van Buchem MA (2006) Intracranial compartment volumes in normal pressure hydrocephalus: volumetric assessment versus outcome. AJNR Am J Neuroradiol 27:76\u201379","journal-title":"AJNR Am J Neuroradiol"},{"key":"5402_CR43","doi-asserted-by":"publisher","first-page":"5300","DOI":"10.1007\/s00330-020-07555-5","volume":"31","author":"HY Park","year":"2021","unstructured":"Park HY, Kim M, Suh CH, Lee DH, Shim WH, Kim SJ (2021) Diagnostic performance and interobserver agreement of the callosal angle and Evans\u2019 index in idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. Eur Radiol 31:5300\u20135311. https:\/\/doi.org\/10.1007\/s00330-020-07555-5","journal-title":"Eur Radiol"},{"key":"5402_CR44","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.3174\/ajnr.A7168","volume":"42","author":"HY Park","year":"2021","unstructured":"Park HY, Park CR, Suh CH, Kim MJ, Shim WH, Kim SJ (2021) Prognostic utility of disproportionately enlarged subarachnoid space hydrocephalus in idiopathic normal pressure hydrocephalus treated with ventriculoperitoneal shunt surgery: a systematic review and meta-analysis. AJNR Am J Neuroradiol 42:1429\u20131436. https:\/\/doi.org\/10.3174\/ajnr.A7168","journal-title":"AJNR Am J Neuroradiol"},{"key":"5402_CR45","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/978-3-7091-6738-0_2","volume":"81","author":"MA Poca","year":"2002","unstructured":"Poca MA, Sahuquillo J, Busto M, Rovira A, Capellades J, Mataro M, Rubio E (2002) Agreement between CSF flow dynamics in MRI and ICP monitoring in the diagnosis of normal pressure hydrocephalus. Sensitivity and specificity of CSF dynamics to predict outcome. Acta Neurochir Suppl 81:7\u201310. https:\/\/doi.org\/10.1007\/978-3-7091-6738-0_2","journal-title":"Acta Neurochir Suppl"},{"key":"5402_CR46","doi-asserted-by":"publisher","first-page":"855","DOI":"10.3171\/jns.2004.100.5.0855","volume":"100","author":"MA Poca","year":"2004","unstructured":"Poca MA, Mataro M, Del Mar MM, Arikan F, Junque C, Sahuquillo J (2004) Is the placement of shunts in patients with idiopathic normal-pressure hydrocephalus worth the risk? Results of a study based on continuous monitoring of intracranial pressure. J Neurosurg 100:855\u2013866. https:\/\/doi.org\/10.3171\/jns.2004.100.5.0855","journal-title":"J Neurosurg"},{"key":"5402_CR47","unstructured":"R-Core-Team. (2020) R: a language and environment for statistical computing. Accessed October 16 2021"},{"issue":"3","key":"5402_CR48","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1093\/neurosurgery\/57.3.N4","volume":"57","author":"N Relkin","year":"2005","unstructured":"Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM (2005) Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 57(3):S4-16","journal-title":"Neurosurgery"},{"key":"5402_CR49","doi-asserted-by":"publisher","first-page":"5299","DOI":"10.3233\/JIFS-189852","volume":"41","author":"B Rudhra","year":"2021","unstructured":"Rudhra B, Malu G, Sherly E, Mathew R (2021) A Novel deep learning approach for the automated diagnosis of normal pressure hydrocephalus. J Intell Fuzzy Syst 41:5299\u20135307. https:\/\/doi.org\/10.3233\/JIFS-189852","journal-title":"J Intell Fuzzy Syst"},{"key":"5402_CR50","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1002\/acn3.685","volume":"6","author":"A Sarica","year":"2019","unstructured":"Sarica A, Curcio M, Rapisarda L, Cerasa A, Quattrone A, Bono F (2019) Periventricular white matter changes in idiopathic intracranial hypertension. Ann Clin Transl Neurol 6:233\u2013242. https:\/\/doi.org\/10.1002\/acn3.685","journal-title":"Ann Clin Transl Neurol"},{"key":"5402_CR51","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.3171\/2016.9.Jns161080","volume":"127","author":"N Shinoda","year":"2017","unstructured":"Shinoda N, Hirai O, Hori S, Mikami K, Bando T, Shimo D, Kuroyama T, Kuramoto Y, Matsumoto M, Ueno Y (2017) Utility of MRI-based disproportionately enlarged subarachnoid space hydrocephalus scoring for predicting prognosis after surgery for idiopathic normal pressure hydrocephalus: clinical research. J Neurosurg 127:1436\u20131442. https:\/\/doi.org\/10.3171\/2016.9.Jns161080","journal-title":"J Neurosurg"},{"key":"5402_CR52","doi-asserted-by":"publisher","first-page":"420","DOI":"10.23736\/s0390-5616.17.04092-9","volume":"64","author":"A Stecco","year":"2020","unstructured":"Stecco A, Cassar\u00e0 A, Zuccal\u00e0 A, Anoaica MB, Genovese E, Car PG, Panzarasa GP, Guzzardi G, Carriero A (2020) Quantitative analysis of cerebrospinal fluid dynamics at phase contrast cine-MRI: predictivity of neurosurgical \u201cShunt\u201d responsiveness in patients with idiopathic normal pressure hydrocephalus. J Neurosurg Sci 64:420\u2013426. https:\/\/doi.org\/10.23736\/s0390-5616.17.04092-9","journal-title":"J Neurosurg Sci"},{"key":"5402_CR53","doi-asserted-by":"publisher","first-page":"i4919","DOI":"10.1136\/bmj.i4919","volume":"355","author":"JA Sterne","year":"2016","unstructured":"Sterne JA, Hernan MA, Reeves BC, Savovic J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hrobjartsson A, Kirkham J, Juni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schunemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 355:i4919. https:\/\/doi.org\/10.1136\/bmj.i4919","journal-title":"BMJ"},{"key":"5402_CR54","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.1007\/s00701-021-04922-z","volume":"163","author":"SG Thavarajasingam","year":"2021","unstructured":"Thavarajasingam SG, El-Khatib M, Rea M, Russo S, Lemcke J, Al-Nusair L, Vajkoczy P (2021) Clinical predictors of shunt response in the diagnosis and treatment of idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. Acta Neurochir (Wien) 163:2641\u20132672. https:\/\/doi.org\/10.1007\/s00701-021-04922-z","journal-title":"Acta Neurochir (Wien)"},{"key":"5402_CR55","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-022-05154-5","author":"SG Thavarajasingam","year":"2022","unstructured":"Thavarajasingam SG, El-Khatib M, Vemulapalli KV, Iradukunda HAS, Laleye J, Russo S, Eichhorn C, Eide PK (2022) Cerebrospinal fluid and venous biomarkers of shunt-responsive idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. Acta Neurochir (Wien). https:\/\/doi.org\/10.1007\/s00701-022-05154-5","journal-title":"Acta Neurochir (Wien)"},{"issue":"10","key":"5402_CR56","doi-asserted-by":"publisher","first-page":"1977","DOI":"10.1007\/s00701-013-1835-5","volume":"155","author":"AK Toma","year":"2013","unstructured":"Toma AK, Papadopoulos MC, Stapleton S, Kitchen ND, Watkins LD (2013) Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus. Acta Neurochir (Wien) 155(10):1977\u20131980. https:\/\/doi.org\/10.1007\/s00701-013-1835-5","journal-title":"Acta Neurochir (Wien)"},{"key":"5402_CR57","unstructured":"VA.;(editors) HJTJCJCMLTPMW (2021) Cochrane handbook for systematic reviews of interventions. Accessed 7 September 2021"},{"key":"5402_CR58","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","volume":"45","author":"S Van Buuren","year":"2011","unstructured":"Van Buuren S, Groothuis-Oudshoorn K (2011) mice: multivariate imputation by chained equations in R. J Stat Softw 45:1\u201367. https:\/\/doi.org\/10.18637\/jss.v045.i03","journal-title":"J Stat Softw"},{"key":"5402_CR59","doi-asserted-by":"publisher","first-page":"178","DOI":"10.3171\/2013.8.Jns13575","volume":"120","author":"J Virhammar","year":"2014","unstructured":"Virhammar J, Laurell K, Cesarini KG, Larsson EM (2014) The callosal angle measured on MRI as a predictor of outcome in idiopathic normal-pressure hydrocephalus. J Neurosurg 120:178\u2013184. https:\/\/doi.org\/10.3171\/2013.8.Jns13575","journal-title":"J Neurosurg"},{"key":"5402_CR60","doi-asserted-by":"publisher","first-page":"2311","DOI":"10.3174\/ajnr.A4046","volume":"35","author":"J Virhammar","year":"2014","unstructured":"Virhammar J, Laurell K, Cesarini KG, Larsson EM (2014) Preoperative prognostic value of MRI findings in 108 patients with idiopathic normal pressure hydrocephalus. AJNR Am J Neuroradiol 35:2311\u20132318. https:\/\/doi.org\/10.3174\/ajnr.A4046","journal-title":"AJNR Am J Neuroradiol"},{"key":"5402_CR61","doi-asserted-by":"publisher","first-page":"4972","DOI":"10.1007\/s00330-020-07531-z","volume":"31","author":"D Wu","year":"2021","unstructured":"Wu D, Moghekar A, Shi W, Blitz AM, Mori S (2021) Systematic volumetric analysis predicts response to CSF drainage and outcome to shunt surgery in idiopathic normal pressure hydrocephalus. Eur Radiol 31:4972\u20134980. https:\/\/doi.org\/10.1007\/s00330-020-07531-z","journal-title":"Eur Radiol"},{"key":"5402_CR62","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1097\/RLU.0b013e31829959a9","volume":"38","author":"SM Yamada","year":"2013","unstructured":"Yamada SM, Masahira N, Kawanishi Y, Fujimoto Y, Shimizu K (2013) Preoperative acetazolamide SPECT is useful for predicting outcome of shunt operation in idiopathic normal pressure hydrocephalus patients. Clin Nucl Med 38:671\u2013676. https:\/\/doi.org\/10.1097\/RLU.0b013e31829959a9","journal-title":"Clin Nucl Med"},{"key":"5402_CR63","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1159\/000347147","volume":"35","author":"D Yamamoto","year":"2013","unstructured":"Yamamoto D, Kazui H, Wada T, Nomura K, Sugiyama H, Shimizu Y, Yoshiyama K, Yoshida T, Kishima H, Yamashita F, Yoshimine T, Takeda M (2013) Association between milder brain deformation before a shunt operation and improvement in cognition and gait in idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 35:197\u2013207. https:\/\/doi.org\/10.1159\/000347147","journal-title":"Dement Geriatr Cogn Disord"},{"key":"5402_CR64","doi-asserted-by":"publisher","first-page":"1533","DOI":"10.1002\/jmri.24292","volume":"39","author":"D Ziegelitz","year":"2014","unstructured":"Ziegelitz D, Starck G, Kristiansen D, Jakobsson M, Hultenmo M, Mikkelsen IK, Hellstr\u00f6m P, Tullberg M, Wikkels\u00f8 C (2014) Cerebral perfusion measured by dynamic susceptibility contrast MRI is reduced in patients with idiopathic normal pressure hydrocephalus. J Magn Reson Imaging 39:1533\u20131542. https:\/\/doi.org\/10.1002\/jmri.24292","journal-title":"J Magn Reson Imaging"},{"key":"5402_CR65","doi-asserted-by":"publisher","first-page":"443","DOI":"10.2214\/ajr.146.3.443","volume":"146","author":"RD Zimmerman","year":"1986","unstructured":"Zimmerman RD, Fleming CA, Lee BC, Saint-Louis LA, Deck MD (1986) Periventricular hyperintensity as seen by magnetic resonance: prevalence and significance. AJR Am J Roentgenol 146:443\u2013450. https:\/\/doi.org\/10.2214\/ajr.146.3.443","journal-title":"AJR Am J Roentgenol"}],"container-title":["Acta Neurochirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-022-05402-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00701-022-05402-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00701-022-05402-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T11:42:24Z","timestamp":1676288544000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00701-022-05402-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,26]]},"references-count":65,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["5402"],"URL":"https:\/\/doi.org\/10.1007\/s00701-022-05402-8","relation":{},"ISSN":["0942-0940"],"issn-type":[{"value":"0942-0940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,26]]},"assertion":[{"value":"8 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was not necessary as this study is a meta-analysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}