{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T08:46:16Z","timestamp":1791708376302,"version":"4.3.4"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Edit Jacobsson donation fund"},{"name":"Adlerbertska Forskningsstiftelsen"},{"DOI":"10.13039\/100010107","name":"Anna-Lisa och Bror Bj\u00f6rnssons Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010107","id-type":"DOI","asserted-by":"publisher"}]},{"name":"G\u00f6teborg Foundation for Neurologic Research"},{"name":"The Swedish state under the agreement between the Swedish government and the County Councils, the Agreements on Medical Education and Research","award":["ALFGBG-1006210"],"award-info":[{"award-number":["ALFGBG-1006210"]}]},{"DOI":"10.13039\/100008448","name":"Rune och Ulla Aml\u00f6vs Stiftelse f\u00f6r Neurologisk och Reumatologisk Forskning","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008448","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neuroradiol J"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) has been proposed as a radiological predictor of shunt responsiveness in idiopathic normal pressure hydrocephalus (iNPH), but previous studies have reported inconsistent results. We investigated the association between preoperative DESH score and postoperative outcome after shunt surgery in a prospective iNPH cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study included 101 consecutive patients with iNPH from the Gothenburg Prediction of Outcome in iNPH (POiNT) study. Preoperative DESH scores were assessed on MRI using previously published criteria. Clinical outcomes included the Gothenburg iNPH scale, modified Rankin Scale (mRS), Mini-Mental State Examination (MMSE), and Timed Up and Go test (TUG-t). The primary outcome was improvement of \u22655 points on the iNPH scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean preoperative DESH score was 6.3 \u00b1 1.7. At follow-up, the mean iNPH scale score improved from 50.8 \u00b1 19.8 to 63.3 \u00b1 20.0 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001), with 70% improving by \u22655 points. Preoperative DESH score was not associated with postoperative change in iNPH scale score (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.123,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .219) or with responder status for any outcome. In multivariable analysis, DESH score was not independently associated with postoperative iNPH scale score after adjustment for baseline iNPH scale score, age, and disease duration. DESH score and Evans\u2019 index decreased and callosal angle increased after surgery (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative DESH score was not associated with postoperative clinical improvement after shunt surgery in patients with iNPH. Although DESH-related imaging markers changed significantly after surgery, baseline DESH score had limited value as an independent predictor of shunt responsiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19714009261494951","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:49:38Z","timestamp":1791398978000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiological DESH score cannot predict outcome after shunt surgery: A Swedish prospective follow-up study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1830-1699","authenticated-orcid":false,"given":"Clara","family":"Constantinescu","sequence":"first","affiliation":[{"name":"University of Gothenburg"},{"name":"Department of Neuropsychiatry, Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1223-7234","authenticated-orcid":false,"given":"Mia","family":"Emg\u00e5rd","sequence":"additional","affiliation":[{"name":"University of Gothenburg"},{"name":"Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Sundstr\u00f6m","sequence":"additional","affiliation":[{"name":"Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Farahmand","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Tullberg","sequence":"additional","affiliation":[{"name":"University of Gothenburg"},{"name":"Sahlgrenska University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6769-3150","authenticated-orcid":false,"given":"Doerthe","family":"Ziegelitz","sequence":"additional","affiliation":[{"name":"University of Gothenburg"},{"name":"University of Gothenburg"},{"name":"Sahlgrenska University Hospital, Region V\u00e4stra G\u00f6taland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9803-7271","authenticated-orcid":false,"given":"Per","family":"Hellstr\u00f6m","sequence":"additional","affiliation":[{"name":"University of Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WN9.0000000000000035"},{"issue":"3","key":"e_1_3_7_3_2","first-page":"S29","article-title":"Surgical management of idiopathic normal-pressure hydrocephalus","volume":"57","author":"Bergsneider M","year":"2005","unstructured":"Bergsneider M, Black PM, Klinge P, et al. 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