{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:12:04Z","timestamp":1790856724111,"version":"4.1.0"},"reference-count":45,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>Summary Introduction: idiopathic normal pressure hydrocephalus (INPH) is characterized by gait apraxia, cognitive dysfunction and urinary incontinence. There are two main treatment options: ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV). However, there are doubts about which modality is superior and what type of valve should be applied. We are summarizing the current evidence in INPH treatment. Methods: an electronic search of the literature was conducted on the Medline, Embase, Scielo and Lilacs databases from 1966 to the present to obtain data published about INPH treatment. Results: the treatment is based on three pillars: conservative, ETV and VPS. The conservative option has fallen into disuse after various studies showing good results after surgical intervention. ETV is an acceptable mode of treatment, but the superiority of VPS has made the latter the gold standard. Conclusion: well-designed studies with a high level of appropriate evidence are still scarce, but the current gold standard for treatment of INPH is conducted using VPS.<\/jats:p>","DOI":"10.1590\/1806-9282.61.03.258","type":"journal-article","created":{"date-parts":[[2015,7,30]],"date-time":"2015-07-30T01:38:28Z","timestamp":1438220308000},"page":"258-262","source":"Crossref","is-referenced-by-count":14,"title":["Evidences in the treatment of idiopathic normal pressure hydrocephalus"],"prefix":"10.1590","volume":"61","author":[{"given":"Matheus Fernandes de","family":"Oliveira","sequence":"first","affiliation":[{"name":"Instituto de Assist\u00eancia M\u00e9dica ao Servidor P\u00fablico Estadual, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo Casimiro","family":"Reis","sequence":"additional","affiliation":[{"name":"IAMSPE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelinda Marramon","family":"Trindade","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Campos Gomes","family":"Pinto","sequence":"additional","affiliation":[{"name":"USP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1056\/NEJM196507152730301","article-title":"Symptomatic occult hydrocephalus with \"normal\" cerebrospinal-fluid pressure: a treatable syndrome","volume":"273","author":"Adams RD","year":"1965","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/S1042-3680(18)30033-0","article-title":"Normal-pressure hydrocephalus","volume":"12","author":"Hakim CA","year":"2001","journal-title":"Neurosurg Clin North Am"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/0022-510X(65)90016-X","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. 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A multicenter study and literature review","volume":"42","author":"Vanneste J","year":"1992","journal-title":"Neurology"},{"key":"ref10","first-page":"877","article-title":"Current treatment of normalpressure hydrocephalus: comparison of flow-regulated and differentialpressure shunt valves","volume":"37","author":"Weiner HL","year":"1995","journal-title":"Neurosurgery"},{"issue":"3","key":"ref11","first-page":"S17","article-title":"The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus","volume":"57","author":"Marmarou A","year":"2005","journal-title":"Neurosurgery"},{"issue":"3","key":"ref12","first-page":"S4","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin N","year":"2005","journal-title":"Neurosurgery"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1111\/j.1600-0404.2007.00982.x","article-title":"Prevalence of probable idiopathic normal 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outcome","volume":"49","author":"Hebb AO","year":"2001","journal-title":"J Neurosurg"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1136\/jnnp.2007.123620","article-title":"Normal pressure hydrocephalus: long-term outcome after shunt surgery","volume":"79","author":"Pujari S","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref37","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD009706.pub2","article-title":"Flow-regulated versus differential pressure-regulated shunt valves for adult patients with normal pressure hydrocephalus","volume":"5","author":"Ziebell M","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1227\/NEU.0000000000000155","article-title":"Predictors of subsequent overdrainage and clinical outcomes after ventriculoperitoneal shunting for idiopathicnormal pressure hydrocephalus","volume":"73","author":"Meier U","year":"2013","journal-title":"Neurosurgery"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1055\/s-0029-1241179","article-title":"Improved outcome in shunted iNPH with a combination of a Codman Hakim programmable valve and an Aesculap-Miethke Shunt Assistant","volume":"71","author":"Lemcke J","year":"2010","journal-title":"Cent Eur Neurosurg"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1227\/NEU.0000000000000126","article-title":"Response to journal club: role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial","volume":"73","author":"Gomes Pinto FC","year":"2013","journal-title":"Neurosurgery"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/978-3-7091-0923-6_24","article-title":"What is the appropriate shunt system for normal pressure hydrocephalus?","volume":"113","author":"Chrissicopoulos C","year":"2012","journal-title":"Acta Neurochir Suppl"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1136\/jnnp-2012-302935","article-title":"A randomised trial of high and low pressure level settings on an adjustable ventriculo peritoneal shunt valve for idiopathic normal pressure hydrocephalus: results of the Dutch evaluation programme Strata shunt (DEPSS) trial","volume":"84","author":"Delwel EJ","year":"2013","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/978-3-7091-0923-6_5","article-title":"Ten years of clinical experience in the use of fixed-pressure versus programmable valves: a retrospective study of 159 patients","volume":"113","author":"Mpakopoulou M","year":"2012","journal-title":"Acta Neurochir Suppl"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.surneu.2004.03.015","article-title":"Comparison of programmable shunt valves vs standard valves for communicating hydrocephalus of adults: a retrospective analysis of 407 patients","volume":"63","author":"Ringel F","year":"2005","journal-title":"Surg Neurol"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1590\/0004-282X20130007","article-title":"Programmable valve represents an efficient and safe tool in the treatment of idiopathic normalpressure hydrocephalus patients","volume":"71","author":"Oliveira MF","year":"2013","journal-title":"Arq Neuropsiquiatr"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ramb\/v61n3\/0104-4230-ramb-61-03-0258.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T21:55:01Z","timestamp":1567029301000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302015000300258&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,6]]}},"alternative-id":["S0104-42302015000300258"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.61.03.258","relation":{},"ISSN":["0104-4230"],"issn-type":[{"value":"0104-4230","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6]]}}}