{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:38:34Z","timestamp":1791196714471,"version":"4.1.0"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Neuro-Psiquiatr."],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:p>Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbance, dementia and \/or urinary incontinence, dilation of the ventricular system and normal opening cerebrospinal fluid pressure. Shunt surgery is the standard treatment of iNHP. Diversions with programmable valves are recommended, once drainage pressure can be changed. However, well-defined protocols still lack guiding the steps to attain proper pressure for each patient.  Methods: In our study, we reported the experience of shunting 24 patients with iNPH using Strata\u00ae (Medtronic) valve, following a protocol based on a positive Tap Test.  Results: We observed clinical improvement in 20 patients and stability\/worsening in 4 patients. Complications occurred in five patients, including one death. The results display improvement, and complications occurred at a lower rate than reported in other studies.  Conclusions: The Strata\u00ae valve used in the proposed protocol represents an efficient and safe tool in the treatment of iNPH.<\/jats:p>","DOI":"10.1590\/0004-282x20130007","type":"journal-article","created":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T16:41:51Z","timestamp":1368204111000},"page":"229-236","source":"Crossref","is-referenced-by-count":36,"title":["Programmable valve represents an efficient and safe tool in the treatment of idiopathic normal-pressure hydrocephalus patients"],"prefix":"10.1590","volume":"71","author":[{"given":"Matheus Fernandes de","family":"Oliveira","sequence":"first","affiliation":[{"name":"Hospital do Servidor P\u00fablico Estadual de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felippe","family":"Saad","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo (USP),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo Casimiro","family":"Reis","sequence":"additional","affiliation":[{"name":"Hospital do Servidor P\u00fablico Estadual de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Marcus","family":"Rotta","sequence":"additional","affiliation":[{"name":"Hospital do Servidor P\u00fablico Estadual de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Campos Gomes","family":"Pinto","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo (USP),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.2176\/nmc.48.S1","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus","volume":"48","author":"Ishikawa M","year":"2008","journal-title":"Neurol Med Chir"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"970","DOI":"10.3171\/jns.2001.95.6.0970","article-title":"Management of idiopathic normal-pressure hydrocephalus: a multiinstitutional study conducted in Japan","volume":"95","author":"Mori K","year":"2001","journal-title":"J Neurosurg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s11910-008-0058-2","article-title":"Normal pressure hydrocephalus: diagnosis and treatment","volume":"8","author":"Shprecher D","year":"2008","journal-title":"Curr Neurol Neurosci Rep"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.2967\/jnumed.107.045310","article-title":"Striatal D2 receptor availability after shunting in idiopathic normal pressure hydrocephalus","volume":"48","author":"Nakayama T","year":"2007","journal-title":"J Nucl Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s10143-011-0316-7","article-title":"Natural history of idiopathic normal-pressure hydrocephalus","volume":"34","author":"Toma AK","year":"2011","journal-title":"Neurosurg Rev"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1159\/000328625","article-title":"Effect of shunt operation on idiopathic normal pressure hydrocephalus patients in reducing caregiver burden: evidence from SINPHONI","volume":"31","author":"Kazui H","year":"2011","journal-title":"Dement Geriatr Cogn Disord"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1007\/s00701-008-0138-8","article-title":"Changes in intracranial pulse pressure amplitudes after shunt implantation and adjustment of shunt valve opening pressure in normal pressure hydrocephalus","volume":"150","author":"Eide PK","year":"2008","journal-title":"Acta Neurochir"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1034\/j.1600-0404.2002.01329.x","article-title":"Cerebral hemodynamics before and after shunting in normal pressure hydrocephalus","volume":"106","author":"Bakker SL","year":"2002","journal-title":"Acta Neurol Scand"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00234-011-0871-1","article-title":"Alteration of brain viscoelasticity after shunt treatment in normal pressure hydrocephalus","volume":"54","author":"Freimann FB","year":"2012","journal-title":"Neuroradiology"},{"key":"ref10","first-page":"S1","article-title":"Neuro imaging genetics studies in basal ganglia calcification as a model to understand brain resilience. 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