{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T01:43:26Z","timestamp":1790991806920,"version":"4.1.0"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Different CSF diversion procedures (ventriculoperitoneal, ventriculoatrial, and lumboperitoneal shunting) have been utilized for the treatment of idiopathic normal pressure hydrocephalus. More recently, endoscopic third ventriculostomy has been suggested as a reasonable alternative in some studies. The purpose of this study was to perform a systematic review and meta-analysis to assess overall rates of favorable outcomes and adverse events for each of these treatments. An additional objective was to determine the outcomes and complication rates in relation to the type of valve utilized (fixed vs programmable).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Multiple databases (PubMed, Ovid MEDLINE In-Process &amp; Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus) were searched for studies involving patients with idiopathic ventriculomegaly, no secondary cause of hydrocephalus, opening pressure &lt; 25 mm Hg on high-volume tap or drainage trial, and age &gt; 60 years. Outcomes included the proportion of patients who showed improvement in gait, cognition, and bladder function. Adverse events considered in the analysis included postoperative ischemic\/hemorrhagic complications, subdural fluid collections, seizures, need for revision surgery, and infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 33 studies, encompassing 2461 patients, were identified. More than 75% of patients experienced improvement after shunting, without significant differences among the different techniques utilized. Overall, gait improvement was observed in 75% of patients, cognitive function improvement in more than 60%, and improvement of incontinence in 55%. Adjustable valves were associated with a reduction in revisions (12% vs 32%) and subdural collections (9% vs 22%) as compared to fixed valves.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Outcomes did not differ significantly among different CSF diversion techniques, and overall improvement was reported in more than 75% of patients. The use of programmable valves decreased the incidence of revision surgery and of subdural collections after surgery, potentially justifying the higher initial cost associated with these valves.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.5.jns1875","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:13:27Z","timestamp":1551226407000},"page":"1024-1036","source":"Crossref","is-referenced-by-count":125,"title":["Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis"],"prefix":"10.3171","volume":"131","author":[{"given":"Enrico","family":"Giordan","sequence":"first","affiliation":[{"name":"Department of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Palandri","sequence":"additional","affiliation":[{"name":"IRCCS Institute of Neurological Sciences of Bologna, Division of Neurosurgery, Bellaria Hospital, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Hassan","family":"Murad","sequence":"additional","affiliation":[{"name":"Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Elder","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1007\/3-211-32318-X_49","article-title":"Three-year outcome of shunted idiopathic NPH patients","volume":"95","author":"Aygok G","year":"2005","unstructured":"Aygok G, Marmarou A, Young HF: Three-year outcome of shunted idiopathic NPH patients. Acta Neurochir Suppl 95:241\u2013245, 20051646385710.1007\/3-211-32318-X_49"},{"key":"b2","series-title":"Turk Neurosurg","first-page":"62","article-title":"Efficacy of lumboperitoneal shunting in patients with normal pressure hydrocephalus","volume":"28","author":"Bayar MA","year":"2018","unstructured":"Bayar MA, Tekiner A, Celik H, Yilmaz A, Menekse G, Yildirim T, : Efficacy of lumboperitoneal shunting in patients with normal pressure hydrocephalus. Turk Neurosurg 28:62\u201366, 201827858384"},{"key":"b3","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1016\/j.jocn.2011.11.019","article-title":"Lumboperitoneal shunts for the treatment of normal pressure hydrocephalus","volume":"19","author":"Bloch O","year":"2012","unstructured":"Bloch O, McDermott MW: Lumboperitoneal shunts for the treatment of normal pressure hydrocephalus. J Clin Neurosci 19:1107\u20131111, 201210.1016\/j.jocn.2011.11.01922705135"},{"key":"b4","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"490","DOI":"10.3171\/jns.1998.88.3.0490","article-title":"Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts","volume":"88","author":"Boon AJ","year":"1998","unstructured":"Boon AJ, Tans JT, Delwel EJ, Egeler-Peerdeman SM, Hanlo PW, Wurzer HA, : Dutch Normal-Pressure Hydrocephalus Study: randomized comparison of low- and medium-pressure shunts. J Neurosurg 88:490\u2013495, 199810.3171\/jns.1998.88.3.04909488303"},{"key":"b5","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.jocn.2016.09.004","article-title":"The predictive value of DESH for shunt responsiveness in idiopathic normal pressure hydrocephalus","volume":"34","author":"Craven CL","year":"2016","unstructured":"Craven CL, Toma AK, Mostafa T, Patel N, Watkins LD: The predictive value of DESH for shunt responsiveness in idiopathic normal pressure hydrocephalus. J Clin Neurosci 34:294\u2013298, 201610.1016\/j.jocn.2016.09.00427692614"},{"key":"b6","series-title":"Contemp Clin Trials","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.cct.2006.04.004","article-title":"Random-effects model for meta-analysis of clinical trials: an update","volume":"28","author":"DerSimonian R","year":"2007","unstructured":"DerSimonian R, Kacker R: Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials 28:105\u2013114, 20071680713110.1016\/j.cct.2006.04.004"},{"key":"b7","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"182","DOI":"10.3171\/2011.11.PEDS11495","article-title":"Preoperative third ventricular bowing as a predictor of endoscopic third ventriculostomy success","volume":"9","author":"Dlouhy BJ","year":"2012","unstructured":"Dlouhy BJ, Capuano AW, Madhavan K, Torner JC, Greenlee JD: Preoperative third ventricular bowing as a predictor of endoscopic third ventriculostomy success. J Neurosurg Pediatr 9:182\u2013190, 201210.3171\/2011.11.PEDS1149522295925"},{"key":"b8","series-title":"Alexandria J Med","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.ajme.2013.11.004","article-title":"Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus","volume":"50","author":"Eshra MA","year":"2014","unstructured":"Eshra MA: Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus. Alexandria J Med 50:341\u2013344, 201410.1016\/j.ajme.2013.11.004"},{"key":"b9","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1002\/ana.25046","article-title":"Deconstructing normal pressure hydrocephalus: ventriculomegaly as early sign of neurodegeneration","volume":"82","author":"Espay AJ","year":"2017","unstructured":"Espay AJ, Da Prat GA, Dwivedi AK, Rodriguez-Porcel F, Vaughan JE, Rosso M, : Deconstructing normal pressure hydrocephalus: ventriculomegaly as early sign of neurodegeneration. Ann Neurol 82:503\u2013513, 201710.1002\/ana.2504628892572"},{"key":"b10","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"2013","DOI":"10.1227\/01.NEU.0000168185.29659.C5","article-title":"Patients benefit from low-pressure settings enabled by gravitational valves in normal pressure hydrocephalus","volume":"115","author":"Freimann FB","year":"1982\u20131986","unstructured":"Freimann FB, Vajkoczy P, Sprung C: Patients benefit from low-pressure settings enabled by gravitational valves in normal pressure hydrocephalus. Clin Neurol Neurosurg 115:1982\u20131986, 201310.1227\/01.NEU.0000168185.29659.C5"},{"key":"b11","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1227\/01.NEU.0000335071.37943.40","article-title":"Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus: an Italian multicenter study","volume":"63","author":"Gangemi M","year":"2008","unstructured":"Gangemi M, Maiuri F, Naddeo M, Godano U, Mascari C, Broggi G, : Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus: an Italian multicenter study. Neurosurgery 63:62\u201369, 200810.1227\/01.NEU.0000335071.37943.4018728569"},{"key":"b12","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"771","DOI":"10.3171\/2014.6.JNS131211","article-title":"Outcome of modern shunt therapy in patients with idiopathic normal pressure hydrocephalus 6 years postoperatively","volume":"121","author":"G\u00f6lz L","year":"2014","unstructured":"G\u00f6lz L, Ruppert FH, Meier U, Lemcke J: Outcome of modern shunt therapy in patients with idiopathic normal pressure hydrocephalus 6 years postoperatively. J Neurosurg 121:771\u2013775, 20142506186910.3171\/2014.6.JNS131211"},{"key":"b13","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"923","DOI":"10.3171\/JNS\/2008\/109\/11\/0923","article-title":"Endoscopic third ventriculostomy in the management of communicating hydrocephalus: a preliminary study","volume":"109","author":"Hailong F","year":"2008","unstructured":"Hailong F, Guangfu H, Haibin T, Hong P, Yong C, Weidong L, : Endoscopic third ventriculostomy in the management of communicating hydrocephalus: a preliminary study. J Neurosurg 109:923\u2013930, 200810.3171\/JNS\/2008\/109\/11\/092318976086"},{"key":"b14","series-title":"Cerebrospinal Fluid Res","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/1743-8454-7-18","article-title":"Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study","volume":"7","author":"Hashimoto M","year":"2010","unstructured":"Hashimoto M, Ishikawa M, Mori E, Kuwana N: Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res 7:18, 201010.1186\/1743-8454-7-1821040519"},{"key":"b15","series-title":"Neurosurgery","first-page":"1166","article-title":"Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome","volume":"49","author":"Hebb AO","year":"2001","unstructured":"Hebb AO, Cusimano MD: Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. Neurosurgery 49:1166\u20131186, 200111846911"},{"key":"b16","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1136\/jnnp.41.11.961","article-title":"Adult idiopathic communicating hydrocephalus with and without shunting","volume":"41","author":"Hughes CP","year":"1978","unstructured":"Hughes CP, Siegel BA, Coxe WS, Gado MH, Grubb RL, Coleman RE, : Adult idiopathic communicating hydrocephalus with and without shunting. J Neurol Neurosurg Psychiatry 41:961\u2013971, 197830950310.1136\/jnnp.41.11.961"},{"key":"b17","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clineuro.2017.03.014","article-title":"Ventriculoatrial versus ventriculoperitoneal shunt complications in idiopathic normal pressure hydrocephalus","volume":"157","author":"Hung AL","year":"2017","unstructured":"Hung AL, Vivas-Buitrago T, Adam A, Lu J, Robison J, Elder BD, : Ventriculoatrial versus ventriculoperitoneal shunt complications in idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg 157:1\u20136, 20172834795710.1016\/j.clineuro.2017.03.014"},{"key":"b18","series-title":"Eur J Neurol","first-page":"122","article-title":"Long-term follow-up of idiopathic normal pressure hydrocephalus treated with ventriculo-peritoneal programmable valve","volume":"22","author":"Ill\u00e1n-Gala I","year":"2015","unstructured":"Ill\u00e1n-Gala I, P\u00e9rez-Lucas J, Mart\u00edn-Montes A, M\u00e1\u00f1ez-Mir\u00f3 J, Ruiz-Ares G, D\u00edez-Tejedor E: Long-term follow-up of idiopathic normal pressure hydrocephalus treated with ventriculo-peritoneal programmable valve. Eur J Neurol 22:122\u2013123, 2015(Abstract)"},{"key":"b19","series-title":"Eur J Neurol","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1111\/ene.13130","article-title":"Health-related quality-of-life outcome in patients with idiopathic normal-pressure hydrocephalus\u2014a 1-year follow-up study","volume":"24","author":"Junkkari A","year":"2017","unstructured":"Junkkari A, H\u00e4yrinen A, Rauramaa T, Sintonen H, Nerg O, Koivisto AM, : Health-related quality-of-life outcome in patients with idiopathic normal-pressure hydrocephalus\u2014a 1-year follow-up study. Eur J Neurol 24:58\u201366, 201710.1111\/ene.1313027647684"},{"key":"b20","series-title":"Fluids Barriers CNS","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12987-016-0048-8","article-title":"A change in brain white matter after shunt surgery in idiopathic normal pressure hydrocephalus: a tract-based spatial statistics study","volume":"14","author":"Kanno S","year":"2017","unstructured":"Kanno S, Saito M, Kashinoura T, Nishio Y, Iizuka O, Kikuchi H, : A change in brain white matter after shunt surgery in idiopathic normal pressure hydrocephalus: a tract-based spatial statistics study. Fluids Barriers CNS 14:1, 20172813264410.1186\/s12987-016-0048-8"},{"key":"b21","series-title":"Lancet Neurol","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1016\/S1474-4422(15)00046-0","article-title":"Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial","volume":"14","author":"Kazui H","year":"2015","unstructured":"Kazui H, Miyajima M, Mori E, Ishikawa M: Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 14:585\u2013594, 20152593424210.1016\/S1474-4422(15)00046-0"},{"key":"b22","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1159\/000068053","article-title":"Extraventricular intracisternal obstructive hydrocephalus\u2014a hypothesis to explain successful 3rd ventriculostomy in communicating hydrocephalus","volume":"38","author":"Kehler U","year":"2003","unstructured":"Kehler U, Gliemroth J: Extraventricular intracisternal obstructive hydrocephalus\u2014a hypothesis to explain successful 3rd ventriculostomy in communicating hydrocephalus. Pediatr Neurosurg 38:98\u2013101, 200310.1159\/00006805312566844"},{"key":"b23","series-title":"Acta Neurol Scand","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/j.1600-0404.2012.01676.x","article-title":"One-year outcome in the European multicentre study on iNPH","volume":"126","author":"Klinge P","year":"2012","unstructured":"Klinge P, Hellstr\u00f6m P, Tans J, Wikkels\u00f8 C: One-year outcome in the European multicentre study on iNPH. Acta Neurol Scand 126:145\u2013153, 201210.1111\/j.1600-0404.2012.01676.x22571428"},{"key":"b24","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1227\/NEU.0b013e31827414b3","article-title":"Poor cognitive outcome in shunt-responsive idiopathic normal pressure hydrocephalus","volume":"72","author":"Koivisto AM","year":"2013","unstructured":"Koivisto AM, Alafuzoff I, Savolainen S, Sutela A, Rummukainen J, Kurki M, : Poor cognitive outcome in shunt-responsive idiopathic normal pressure hydrocephalus. Neurosurgery 72:1\u20138, 201310.1227\/NEU.0b013e31827414b323037817"},{"key":"b25","series-title":"Dement Geriatr Cogn Disord","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1159\/000111149","article-title":"Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus","volume":"25","author":"Kubo Y","year":"2008","unstructured":"Kubo Y, Kazui H, Yoshida T, Kito Y, Kimura N, Tokunaga H, : Validation of grading scale for evaluating symptoms of idiopathic normal-pressure hydrocephalus. Dement Geriatr Cogn Disord 25:37\u201345, 20081802582810.1159\/000111149"},{"key":"b26","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/978-3-7091-0956-4_50","article-title":"Idiopathic normal pressure hydrocephalus (iNPH) and co-morbidity: an outcome analysis of 134 patients","volume":"114","author":"Lemcke J","year":"2012","unstructured":"Lemcke J, Meier U: Idiopathic normal pressure hydrocephalus (iNPH) and co-morbidity: an outcome analysis of 134 patients. Acta Neurochir Suppl 114:255\u2013259, 201210.1007\/978-3-7091-0956-4_5022327704"},{"key":"b27","series-title":"BMJ","doi-asserted-by":"publisher","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration","volume":"339","author":"Liberati A","year":"2009","unstructured":"Liberati A, Altman DG, Tetzlaff J, Mulrow C, G\u00f8tzsche PC, Ioannidis JP, : The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700, 200910.1136\/bmj.b270019622552"},{"key":"b28","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.clineuro.2016.02.013","article-title":"Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus","volume":"143","author":"Liu A","year":"2016","unstructured":"Liu A, Sankey EW, Jusu\u00e9-Torres I, Patel MA, Elder BD, Goodwin CR, : Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg 143:34\u201338, 20162689520710.1016\/j.clineuro.2016.02.013"},{"key":"b29","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1016\/j.clineuro.2013.02.015","article-title":"Postural function in idiopathic normal pressure hydrocephalus before and after shunt surgery: a controlled study using computerized dynamic posturography (EquiTest)","volume":"115","author":"Lundin F","year":"2013","unstructured":"Lundin F, Ledin T, Wikkels\u00f8 C, Leijon G: Postural function in idiopathic normal pressure hydrocephalus before and after shunt surgery: a controlled study using computerized dynamic posturography (EquiTest). Clin Neurol Neurosurg 115:1626\u20131631, 20132348944410.1016\/j.clineuro.2013.02.015"},{"key":"b30","series-title":"Acta Neurol Scand","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1111\/j.1600-0404.2010.01432.x","article-title":"Cerebrospinal fluid dynamics and long-term survival of the Strata valve in idiopathic normal pressure hydrocephalus","volume":"124","author":"Lundkvist B","year":"2011","unstructured":"Lundkvist B, Koskinen LO, Birgander R, Eklund A, Malm J: Cerebrospinal fluid dynamics and long-term survival of the Strata valve in idiopathic normal pressure hydrocephalus. Acta Neurol Scand 124:115\u2013121, 20112103936310.1111\/j.1600-0404.2010.01432.x"},{"key":"b31","series-title":"Clin Neurol Neurosurg","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.clineuro.2017.05.020","article-title":"A simplified pressure adjustment clinical pathway for programmable valves in NPH patients","volume":"159","author":"Ma TS","year":"2017","unstructured":"Ma TS, Sharma N, Grady MS: A simplified pressure adjustment clinical pathway for programmable valves in NPH patients. Clin Neurol Neurosurg 159:83\u201386, 20172858268810.1016\/j.clineuro.2017.05.020"},{"issue":"3 Suppl","key":"b32","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.1227\/01.NEU.0000168184.01002.60","article-title":"The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus","volume":"57","author":"Marmarou A","year":"2005","unstructured":"Marmarou A, Bergsneider M, Klinge P, Relkin N, Black PML: The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery 57 (3 Suppl):S17\u2013S28, ii\u2013v, 200510.1227\/01.NEU.0000168184.01002.60"},{"key":"b33","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1227\/01.NEU.0000175724.00147.10","article-title":"Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus","volume":"57","author":"McGirt MJ","year":"2005","unstructured":"McGirt MJ, Woodworth G, Coon AL, Thomas G, Williams MA, Rigamonti D: Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus. Neurosurgery 57:699\u2013705, 20051623988210.1227\/01.NEU.0000175724.00147.10"},{"key":"b34","series-title":"Neurosurg Q","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1097\/01.wnq.0000135757.45404.9a","article-title":"Outcome of idiopathic normal-pressure hydrocephalus after surgery with gravity valves","volume":"14","author":"Meier U","year":"2004","unstructured":"Meier U: Outcome of idiopathic normal-pressure hydrocephalus after surgery with gravity valves. Neurosurg Q 14:119\u2013126, 200410.1097\/01.wnq.0000135757.45404.9a"},{"key":"b35","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"775","DOI":"10.2176\/nmc.52.775","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus: second edition","volume":"52","author":"Mori E","year":"2012","unstructured":"Mori E, Ishikawa M, Kato T, Kazui H, Miyake H, Miyajima M, : Guidelines for management of idiopathic normal pressure hydrocephalus: second edition. Neurol Med Chir (Tokyo) 52:775\u2013809, 201210.2176\/nmc.52.77523183074"},{"key":"b36","series-title":"J Neurosurg","doi-asserted-by":"publisher","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","unstructured":"Mori K: Management of idiopathic normal-pressure hydrocephalus: a multiinstitutional study conducted in Japan. J Neurosurg 95:970\u2013973, 200110.3171\/jns.2001.95.6.097011765841"},{"key":"b37","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e0119973","DOI":"10.1371\/journal.pone.0119973","article-title":"Impact of cerebrospinal fluid shunting for idiopathic normal pressure hydrocephalus on the amyloid cascade","volume":"10","author":"Moriya M","year":"2015","unstructured":"Moriya M, Miyajima M, Nakajima M, Ogino I, Arai H: Impact of cerebrospinal fluid shunting for idiopathic normal pressure hydrocephalus on the amyloid cascade. PLoS One 10:e0119973, 20152582195810.1371\/journal.pone.0119973"},{"key":"b38","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/j.wneu.2014.08.004","article-title":"Use of external lumbar cerebrospinal fluid drainage and lumboperitoneal shunts with Strata NSC valves in idiopathic normal pressure hydrocephalus: a single-center experience","volume":"83","author":"Nakajima M","year":"2015","unstructured":"Nakajima M, Miyajima M, Ogino I, Sugano H, Akiba C, Domon N, : Use of external lumbar cerebrospinal fluid drainage and lumboperitoneal shunts with Strata NSC valves in idiopathic normal pressure hydrocephalus: a single-center experience. World Neurosurg 83:387\u2013393, 20152510829310.1016\/j.wneu.2014.08.004"},{"key":"b39","series-title":"Arq Neuropsiquiatr","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1590\/0004-282X20130007","article-title":"Programmable valve represents an efficient and safe tool in the treatment of idiopathic normal-pressure hydrocephalus patients","volume":"71","author":"Oliveira MF","year":"2013","unstructured":"Oliveira MF, Saad F, Reis RC, Rotta JM, Pinto FC: Programmable valve represents an efficient and safe tool in the treatment of idiopathic normal-pressure hydrocephalus patients. Arq Neuropsiquiatr 71:229\u2013236, 201310.1590\/0004-282X2013000723588284"},{"key":"b40","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1007\/978-3-7091-0923-6_25","article-title":"Indications for endoscopic third ventriculostomy in normal pressure hydrocephalus","volume":"113","author":"Paidakakos N","year":"2012","unstructured":"Paidakakos N, Borgarello S, Naddeo M: Indications for endoscopic third ventriculostomy in normal pressure hydrocephalus. Acta Neurochir Suppl 113:123\u2013127, 201210.1007\/978-3-7091-0923-6_2522116437"},{"key":"b41","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"776","DOI":"10.3171\/2014.6.JNS132003","article-title":"Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus","volume":"121","author":"Petersen J","year":"2014","unstructured":"Petersen J, Hellstr\u00f6m P, Wikkels\u00f8 C, Lundgren-Nilsson A: Improvement in social function and health-related quality of life after shunt surgery for idiopathic normal-pressure hydrocephalus. J Neurosurg 121:776\u2013784, 20142503619410.3171\/2014.6.JNS132003"},{"key":"b42","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1227\/NEU.0b013e318285b37c","article-title":"Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial","volume":"72","author":"Pinto FC","year":"2013","unstructured":"Pinto FC, Saad F, Oliveira MF, Pereira RM, Miranda FL, Tornai JB, : Role of endoscopic third ventriculostomy and ventriculoperitoneal shunt in idiopathic normal pressure hydrocephalus: preliminary results of a randomized clinical trial. Neurosurgery 72:845\u2013854, 20132331397710.1227\/NEU.0b013e318285b37c"},{"key":"b43","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","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","unstructured":"Pujari S, Kharkar S, Metellus P, Shuck J, Williams MA, Rigamonti D: Normal pressure hydrocephalus: long-term outcome after shunt surgery. J Neurol Neurosurg Psychiatry 79:1282\u20131286, 200810.1136\/jnnp.2007.12362018356257"},{"key":"b44","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1097\/00006123-199601000-00014","article-title":"Prospective analysis by computed tomography and long-term outcome of 23 adult patients with chronic idiopathic hydrocephalus","volume":"38","author":"Raftopoulos C","year":"1996","unstructured":"Raftopoulos C, Massager N, Bal\u00e9riaux D, Deleval J, Clarysse S, Brotchi J: Prospective analysis by computed tomography and long-term outcome of 23 adult patients with chronic idiopathic hydrocephalus. Neurosurgery 38:51\u201359, 199610.1097\/00006123-199601000-000148747951"},{"key":"b45","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.wneu.2011.06.038","article-title":"The role of endoscopic third ventriculostomy in the treatment of communicating hydrocephalus","volume":"77","author":"Rangel-Castilla L","year":"2012","unstructured":"Rangel-Castilla L, Barber S, Zhang YJ: The role of endoscopic third ventriculostomy in the treatment of communicating hydrocephalus. World Neurosurg 77:555\u2013560, 20122212035010.1016\/j.wneu.2011.06.038"},{"issue":"3 Suppl","key":"b46","series-title":"Neurosurgery","first-page":"S4","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin N","year":"2005","unstructured":"Relkin N, Marmarou A, Klinge P, Bergsneider M, Black PM: Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 57 (3 Suppl):S4\u2013S16, ii\u2013v, 2005"},{"key":"b47","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1016\/j.jocn.2015.02.019","article-title":"Functional gait outcomes for idiopathic normal pressure hydrocephalus after primary endoscopic third ventriculostomy","volume":"22","author":"Sankey EW","year":"2015","unstructured":"Sankey EW, Jusu\u00e9-Torres I, Elder BD, Goodwin CR, Batra S, Hoffberger J, : Functional gait outcomes for idiopathic normal pressure hydrocephalus after primary endoscopic third ventriculostomy. J Clin Neurosci 22:1303\u20131308, 20152597925610.1016\/j.jocn.2015.02.019"},{"key":"b48","series-title":"Mov Disord Clin Pract (Hoboken)","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1002\/mdc3.12335","article-title":"A review of clinical outcomes for gait and other variables in the surgical treatment of idiopathic normal pressure hydrocephalus","volume":"3","author":"Shaw R","year":"2016","unstructured":"Shaw R, Mahant N, Jacobson E, Owler B: A review of clinical outcomes for gait and other variables in the surgical treatment of idiopathic normal pressure hydrocephalus. Mov Disord Clin Pract (Hoboken) 3:331\u2013341, 201610.1002\/mdc3.12335"},{"key":"b49","series-title":"Neurol Res","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1179\/174313209X380784","article-title":"Ultrasound guidance for distal insertion of ventriculo-atrial shunt catheters: technical note","volume":"31","author":"Sheth SA","year":"2009","unstructured":"Sheth SA, McGirt M, Woodworth G, Wang P, Rigamonti D: Ultrasound guidance for distal insertion of ventriculo-atrial shunt catheters: technical note. Neurol Res 31:280\u2013282, 200910.1179\/174313209X38078419040795"},{"key":"b50","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1227\/01.NEU.0000230259.49167.95","article-title":"Impact of cerebrovascular disease on the surgical treatment of idiopathic normal pressure hydrocephalus","volume":"59","author":"Spagnoli D","year":"2006","unstructured":"Spagnoli D, Innocenti L, Bello L, Pluderi M, Bacigaluppi S, Tomei G, : Impact of cerebrovascular disease on the surgical treatment of idiopathic normal pressure hydrocephalus. Neurosurgery 59:545\u2013552, 200610.1227\/01.NEU.0000230259.49167.9516955036"},{"key":"b51","series-title":"Acta Neurochir Suppl","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/978-3-7091-0923-6_23","article-title":"Twelve-year hospital outcomes in patients with idiopathic hydrocephalus","volume":"113","author":"Stranjalis G","year":"2012","unstructured":"Stranjalis G, Kalamatianos T, Koutsarnakis C, Loufardaki M, Stavrinou L, Sakas DE: Twelve-year hospital outcomes in patients with idiopathic hydrocephalus. Acta Neurochir Suppl 113:115\u2013117, 201210.1007\/978-3-7091-0923-6_2322116435"},{"key":"b52","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1007\/s00701-015-2345-4","article-title":"Optimized surgical treatment for normal pressure hydrocephalus: comparison between gravitational and differential pressure valves","volume":"157","author":"Suchorska B","year":"2015","unstructured":"Suchorska B, Kunz M, Schniepp R, Jahn K, Goetz C, Tonn JC, : Optimized surgical treatment for normal pressure hydrocephalus: comparison between gravitational and differential pressure valves. Acta Neurochir (Wien) 157:703\u2013709, 201510.1007\/s00701-015-2345-425666108"},{"key":"b53","series-title":"Dement Geriatr Cogn Disord","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1159\/000087092","article-title":"Baseline neuropsychological profile and cognitive response to cerebrospinal fluid shunting for idiopathic normal pressure hydrocephalus","volume":"20","author":"Thomas G","year":"2005","unstructured":"Thomas G, McGirt MJ, Woodworth G, Heidler J, Rigamonti D, Hillis AE, : Baseline neuropsychological profile and cognitive response to cerebrospinal fluid shunting for idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 20:163\u2013168, 200510.1159\/00008709216020945"},{"key":"b54","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1007\/s00701-017-3171-7","article-title":"Shunting of the over 80s in normal pressure hydrocephalus","volume":"159","author":"Thompson SD","year":"2017","unstructured":"Thompson SD, Shand Smith JD, Khan AA, Luoma AMV, Toma AK, Watkins LD: Shunting of the over 80s in normal pressure hydrocephalus. Acta Neurochir (Wien) 159:987\u2013994, 201710.1007\/s00701-017-3171-728421283"},{"key":"b55","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1977","DOI":"10.1007\/s00701-013-1835-5","article-title":"Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus","volume":"155","author":"Toma AK","year":"2013","unstructured":"Toma AK, Papadopoulos MC, Stapleton S, Kitchen ND, Watkins LD: Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus. Acta Neurochir (Wien) 155:1977\u20131980, 20132397564610.1007\/s00701-013-1835-5"},{"key":"b56","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1007\/s00701-013-1934-3","article-title":"Overcoming CSF overdrainage with the adjustable gravitational valve proSA","volume":"156","author":"Tschan CA","year":"2014","unstructured":"Tschan CA, Antes S, Huthmann A, Vulcu S, Oertel J, Wagner W: Overcoming CSF overdrainage with the adjustable gravitational valve proSA. Acta Neurochir (Wien) 156:767\u2013776, 201410.1007\/s00701-013-1934-324292775"},{"key":"b57","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s00701-017-3394-7","article-title":"Shunt surgery in idiopathic normal pressure hydrocephalus is cost-effective\u2014a cost utility analysis","volume":"160","author":"Tullberg M","year":"2018","unstructured":"Tullberg M, Persson J, Petersen J, Hellstrom P, Wikkelso C, Lundgren-Nilsson A: Shunt surgery in idiopathic normal pressure hydrocephalus is cost-effective\u2014a cost utility analysis. Acta Neurochir (Wien) 160:509\u2013518, 20182915079410.1007\/s00701-017-3394-7"},{"key":"b58","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"2311","DOI":"10.3174\/ajnr.A4046","article-title":"Preoperative prognostic value of MRI findings in 108 patients with idiopathic normal pressure hydrocephalus","volume":"35","author":"Virhammar J","year":"2014","unstructured":"Virhammar J, Laurell K, Cesarini KG, Larsson EM: Preoperative prognostic value of MRI findings in 108 patients with idiopathic normal pressure hydrocephalus. AJNR Am J Neuroradiol 35:2311\u20132318, 201410.3174\/ajnr.A404625012669"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/131\/4\/article-p1024.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/131\/4\/article-p1024.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/131\/4\/article-p1024.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T03:58:24Z","timestamp":1742702304000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/131\/4\/article-p1024.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":58,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2018.5.jns1875","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}