{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T06:51:40Z","timestamp":1794639100538,"version":"4.9.1"},"reference-count":64,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T00:00:00Z","timestamp":1325808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropathology Appl Neurobio"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:p>V. Leinonen, A. M. Koivisto, S. Savolainen, J. Rummukainen, A. Sutela, R. Vanninen, J. E. J\u00e4\u00e4skel\u00e4inen, H. Soininen and I. Alafuzoff (2012) <jats:italic>Neuropathology and Applied Neurobiology<\/jats:italic><jats:bold>38,<\/jats:bold> 72\u201386<\/jats:p><jats:p><jats:bold>Post\u2010mortem findings in 10 patients with presumed normal\u2010pressure hydrocephalus and review of the literature<\/jats:bold><\/jats:p><jats:p><jats:bold>Aims:<\/jats:bold> Neuropathological features of idiopathic normal\u2010pressure hydrocephalus (iNPH) are poorly characterized. Brain biopsy during life may help in the differential diagnosis of dementia, but post\u2010mortem validation of biopsy findings is scarce. Here we review and report brain biopsy and post\u2010mortem neuropathological findings in patients with presumed NPH. <jats:bold>Methods:<\/jats:bold> We evaluated 10 patients initially investigated by intraventricular pressure monitoring and a frontal cortical biopsy for histological and immunohistochemical assessment as a diagnostic procedure for presumed NPH. <jats:bold>Results:<\/jats:bold> Out of the 10 patients, eight were shunted and seven benefited. Until death, six had developed severe and two mild cognitive impairment. One was cognitively unimpaired, and one was mentally retarded. Three subjects displayed amyloid\u2010\u03b2 (A\u03b2) aggregates in their frontal cortical biopsy obtained at the initial procedure. One of these patients developed Alzheimer's disease during a follow\u2010up time of nearly 10 years. One patient with cognitive impairment and NPH suffered from corticobasal degeneration. In six patients various vascular lesions were seen at the final neuropathological investigation. Five of them were cognitively impaired, and in four vascular lesions were seen sufficient in extent to be considered as causative regarding their symptoms. <jats:bold>Conclusions:<\/jats:bold> The frequent finding of vascular pathology in NPH is intriguing, suggesting that vascular alterations might be causative of cognitive impairment in a notable number of patients with NPH and dementia. Brain biopsy can be used to detect A\u03b2 aggregates, but neuropathological characteristics of iNPH as a distinct disease still need to be discovered.<\/jats:p>","DOI":"10.1111\/j.1365-2990.2011.01195.x","type":"journal-article","created":{"date-parts":[[2011,6,23]],"date-time":"2011-06-23T06:49:10Z","timestamp":1308811750000},"page":"72-86","source":"Crossref","is-referenced-by-count":96,"title":["Post\u2010mortem findings in 10 patients with presumed normal\u2010pressure hydrocephalus and review of the literature"],"prefix":"10.1111","volume":"38","author":[{"given":"V.","family":"Leinonen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. M.","family":"Koivisto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Savolainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Rummukainen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Sutela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Vanninen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. E.","family":"J\u00e4\u00e4skel\u00e4inen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Soininen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Alafuzoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,6]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000168185.29659.C5"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22100"},{"key":"e_1_2_8_4_2","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1227\/01.NEU.0000168186.45363.4D","article-title":"Surgical management of idiopathic normal\u2010pressure hydrocephalus","volume":"57","author":"Bergsneider M","year":"2005","journal-title":"Neurosurgery"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000316271.90090.b9"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000363408.69856.B8"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1973.00490290039003"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1974.41.4.0463"},{"key":"e_1_2_8_9_2","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1227\/00006123-197905000-00011","article-title":"Adult dementia: history, biopsy, pathology","volume":"4","author":"Torack RM","year":"1979","journal-title":"Neurosurgery"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-88437-5"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.59.6.608"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199703000-00013"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.095117"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100021442"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.68.6.778"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-40733"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007010050386"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22015"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.30.9.998"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh543"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-010-0721-y"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/33.6.815"},{"key":"e_1_2_8_23_2","first-page":"349","article-title":"Congophilic angiopathy complicated by surgery and massive hemorrhage. A light and electron microscopic study","volume":"81","author":"Torack RM","year":"1975","journal-title":"Am J Pathol"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2990.1988.tb00880.x"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-4580(93)90043-B"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.56.10.1254"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_2_8_28_2","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, DSM IV","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.149.2.351"},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.1159\/000081050"},{"key":"e_1_2_8_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.65.10.noc80013"},{"key":"e_1_2_8_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-002-0936-3"},{"key":"e_1_2_8_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.jnen.0000229986.17548.27"},{"key":"e_1_2_8_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-006-0127-z"},{"key":"e_1_2_8_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-3639.2008.00147.x"},{"key":"e_1_2_8_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/nen.0b013e3181633526"},{"key":"e_1_2_8_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-008-0358-2"},{"key":"e_1_2_8_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-009-0523-2"},{"key":"e_1_2_8_39_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-009-0485-4"},{"key":"e_1_2_8_40_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.12.1791"},{"key":"e_1_2_8_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00308809"},{"key":"e_1_2_8_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-4580(97)00056-0"},{"key":"e_1_2_8_43_2","doi-asserted-by":"publisher","DOI":"10.1148\/95.1.109"},{"key":"e_1_2_8_44_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.23.10.1058"},{"key":"e_1_2_8_45_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1974.00490400076009"},{"key":"e_1_2_8_46_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1974.00490350045007"},{"key":"e_1_2_8_47_2","first-page":"785","article-title":"Chronic communicating hydrocephalus with normal CSE pressures: a cisternographic\u2010pathologic correlation","volume":"17","author":"Vessal K","year":"1974","journal-title":"Ann Radiol (Paris)"},{"key":"e_1_2_8_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(77)90139-3"},{"key":"e_1_2_8_49_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.40.1.73"},{"key":"e_1_2_8_50_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100025348"},{"key":"e_1_2_8_51_2","first-page":"97","article-title":"Normal pressure hydrocephalus. Neuropathological study","volume":"37","author":"Akai K","year":"1987","journal-title":"Acta Pathol Jpn"},{"key":"e_1_2_8_52_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.52.6.804"},{"key":"e_1_2_8_53_2","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511526886.020"},{"key":"e_1_2_8_54_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/58.1.58"},{"key":"e_1_2_8_55_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.23.3.234"},{"key":"e_1_2_8_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2990.1987.tb00070.x"},{"key":"e_1_2_8_57_2","first-page":"83","article-title":"Neuropathological aspects of dementias resulting from abnormal blood and cerebrospinal fluid dynamics","volume":"76","author":"Jellinger K","year":"1976","journal-title":"Acta Neurol Belg"},{"key":"e_1_2_8_58_2","first-page":"351","article-title":"Anatomopathological study of dementia syndrome linked with an abnormal cerebrospinal fluid flow. Report of literature and personal observations","volume":"83","author":"Brusa G","year":"1991","journal-title":"Pathologica"},{"key":"e_1_2_8_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2009.12.065"},{"key":"e_1_2_8_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/1743-8454-6-4"},{"key":"e_1_2_8_61_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1197623"},{"key":"e_1_2_8_62_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-009-0624-y"},{"key":"e_1_2_8_63_2","doi-asserted-by":"publisher","DOI":"10.1002\/ddrr.94"},{"key":"e_1_2_8_64_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-3639.2004.tb00072.x"},{"key":"e_1_2_8_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0072-9752(07)01278-X"}],"container-title":["Neuropathology and Applied Neurobiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2990.2011.01195.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2990.2011.01195.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T19:11:26Z","timestamp":1698693086000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2990.2011.01195.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1,6]]},"references-count":64,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2012,2]]}},"alternative-id":["10.1111\/j.1365-2990.2011.01195.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2990.2011.01195.x","archive":["Portico"],"relation":{},"ISSN":["0305-1846","1365-2990"],"issn-type":[{"value":"0305-1846","type":"print"},{"value":"1365-2990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1,6]]}}}