{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T03:55:46Z","timestamp":1775447746592,"version":"3.50.1"},"reference-count":28,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"unspecified","delay-in-days":119,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Neurol Open"],"accepted":{"date-parts":[[2025,3,29]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Long-standing overt ventriculomegaly in adults (LOVA) has been posited as a form of progressive hydrocephalus, with similar clinical and radiographic features to normal pressure hydrocephalus (NPH), but which should be understood as a distinct clinical entity. We conducted a narrative review analysing the literature into LOVA as a distinct form of hydrocephalus with its own clinical and radiographic characteristics and treatment modalities. LOVA is characterised by triventriculomegaly, an Evans\u2019 index of \u22650.4, presenting with progressive symptoms of elevated intracranial pressure after an initial arrest in childhood and head circumferences\u22652 SD above the mean. Endoscopic third ventriculostomy is considered the first-line treatment. Shunting is equally effective but confers a higher complication risk profile. LOVA represents a progressive form of hydrocephalus with certain clinical and radiographic features which overlap with NPH, but is a distinct entity which should be on the neurologist\u2019s differential.<\/jats:p>","DOI":"10.1136\/bmjno-2024-001021","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T10:45:14Z","timestamp":1746096314000},"page":"e001021","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Long-standing overt ventriculomegaly in adults (LOVA) as a distinct entity on the neurologist\u2019s differential: a narrative review"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0927-4924","authenticated-orcid":false,"given":"Racheed","family":"Mani","sequence":"first","affiliation":[{"name":"Department of Neurology, Stony Brook University Hospital, Stony Brook, New York, 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