{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T12:04:18Z","timestamp":1784981058213,"version":"3.55.0"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>MRI volumetry could be used as an alternative to invasive tests of shunt function. In this study, the authors aimed to assess the difference in ventricular volume (VV) before and after surgery and at different performance levels (PLs) of the shunt.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This study was a randomized, double-blind trial with a crossover design. The study sample consisted of 36 patients (25 men, 11 women) with a median age of 76 years. All patients had idiopathic normal pressure hydrocephalus (iNPH) and received a Strata shunt at the regional hospital in \u00d6stersund, Sweden, with an initial PL of 1.5. Participants underwent MRI with volumetric sequences before surgery and four times postoperatively: at 1 month before randomization to either PL 1.0 (n = 15) or 2.5 (n = 17); at 2 months before crossover to PL 2.5 or 1.0; at 3 months before lowering the PL to 0.5; and finally, at 3 months and 1 day after surgery before resetting the PL to 1.5. VV was measured semiautomatically using quantitative MRI. Both the patient and the examiner of clinical tests and volumetry were blinded to the PL.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>VV changed significantly between the presurgical level (median 129 ml) and the different shunt settings, i.e., PL 1.0 (median 115 ml), 1.5 (median 120 ml), and 2.5 (median 128 ml; p &lt; 0.001). A unidirectional change in VV was observed for all participants between PL 1.0 and PL 2.5 (median 12 ml, range 2.1\u201340.7 ml, p &lt; 0.001). No significant change was noted in VV after 24 hours at PL 0.5. Eight participants had asymptomatic subdural effusions at PL 1.0.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The consistent decrease in VV after shunt surgery and between PL 2.5 and 1.0 supports the idea that MRI volumetry could be a noninvasive method for evaluating shunt function in iNPH, preventing unnecessary shunt revisions. However, further studies on retest variability of VV as well as verification against advanced testing of shunt function are needed before a clinical implementation of this method can be performed.<\/jats:p>\n<jats:p>Clinical trial registration no.: NCT04599153 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>)<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.9.jns23668","type":"journal-article","created":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T01:27:51Z","timestamp":1700270871000},"page":"1493-1500","source":"Crossref","is-referenced-by-count":3,"title":["Volumetric effect of shunt adjustments in normal pressure hydrocephalus: a randomized, double-blind trial"],"prefix":"10.3171","volume":"140","author":[{"given":"Simon","family":"Lid\u00e9n","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Neurology, Uppsala University, Uppsala L\u00e4n"},{"name":"Department of Neurology, \u00d6stersund Hospital, \u00d6stersund, Region J\u00e4mtland H\u00e4rjedalen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Farahmand","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, V\u00e4stra G\u00f6talands L\u00e4n; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Laurell","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Neurology, Uppsala University, Uppsala L\u00e4n"},{"name":"Department of Biomedical and Clinical Sciences, Neurology, Link\u00f6ping University, Link\u00f6ping, \u00d6sterg\u00f6tlands L\u00e4n, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Neurosurg","first-page":"1024","article-title":"Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis","volume":"131","author":"Giordan E","year":"2019","unstructured":"Giordan E, Palandri G, Lanzino G, Murad MH, Elder BD. Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. J Neurosurg. 2019;131(4):1024\u20131036."},{"key":"b2","series-title":"World Neurosurg","first-page":"e458","article-title":"Long-term efficacy of shunt therapy in idiopathic normal pressure hydrocephalus","volume":"129","author":"Grasso G","year":"2019","unstructured":"Grasso G, Torregrossa F, Leone L, Frisella A, Landi A. Long-term efficacy of shunt therapy in idiopathic normal pressure hydrocephalus. World Neurosurg. 2019;129:e458\u2013e463."},{"issue":"1","key":"b3","series-title":"Oper Neurosurg (Hagerstown)","first-page":"97","article-title":"Ventriculoperitoneal shunt complications in the European idiopathic normal pressure hydrocephalus multicenter study","volume":"17","author":"Feletti A","year":"2019","unstructured":"Feletti A, d\u2019Avella D, Wikkels\u00f8 C,  Ventriculoperitoneal shunt complications in the European idiopathic normal pressure hydrocephalus multicenter study. Oper Neurosurg (Hagerstown). 2019;17(1):97\u2013102."},{"issue":"5","key":"b4","series-title":"J Clin Med","first-page":"1286","article-title":"Clinical outcomes of shunting in normal pressure hydrocephalus: a multicenter prospective observational study","volume":"11","author":"Trungu S","year":"2022","unstructured":"Trungu S, Scollato A, Ricciardi L,  Clinical outcomes of shunting in normal pressure hydrocephalus: a multicenter prospective observational study. J Clin Med. 2022;11(5):1286."},{"issue":"1","key":"b5","series-title":"J Neurol","first-page":"178","article-title":"Long-term effects of complications and vascular comorbidity in idiopathic normal pressure hydrocephalus: a quality registry study","volume":"265","author":"Andr\u00e9n K","year":"2018","unstructured":"Andr\u00e9n K, Wikkels\u00f6 C, Sundstr\u00f6m N,  Long-term effects of complications and vascular comorbidity in idiopathic normal pressure hydrocephalus: a quality registry study. J Neurol. 2018;265(1):178\u2013186."},{"issue":"2 Dementia","key":"b6","series-title":"Continuum (Minneap Minn)","first-page":"579","article-title":"Diagnosis and treatment of idiopathic normal pressure hydrocephalus","volume":"22","author":"Williams MA","year":"2016","unstructured":"Williams MA, Malm J. Diagnosis and treatment of idiopathic normal pressure hydrocephalus. Continuum (Minneap Minn). 2016;22(2 Dementia):579\u2013599."},{"issue":"5","key":"b7","series-title":"Neurosurgery","first-page":"909","article-title":"Radionuclide shunt patency study for evaluation of suspected ventriculoperitoneal shunt malfunction in adults with normal pressure hydrocephalus","volume":"64","author":"Kharkar S","year":"2009","unstructured":"Kharkar S, Shuck J, Kapoor S, Batra S, Williams MA, Rigamonti D. Radionuclide shunt patency study for evaluation of suspected ventriculoperitoneal shunt malfunction in adults with normal pressure hydrocephalus. Neurosurgery. 2009;64(5):909\u2013918."},{"key":"b8","series-title":"World Neurosurg","first-page":"e479","article-title":"Diagnosis of ventriculoperitoneal shunt malfunction: a practical algorithm","volume":"137","author":"Broggi M","year":"2020","unstructured":"Broggi M, Zattra CM, Schiariti M,  Diagnosis of ventriculoperitoneal shunt malfunction: a practical algorithm. World Neurosurg. 2020;137:e479\u2013e486."},{"issue":"5","key":"b9","series-title":"Acta Neurol Scand","first-page":"317","article-title":"In vivo assessment of hydrocephalus shunt","volume":"120","author":"Petrella G","year":"2009","unstructured":"Petrella G, Czosnyka M, Smielewski P,  In vivo assessment of hydrocephalus shunt. Acta Neurol Scand. 2009;120(5):317\u2013323."},{"issue":"8","key":"b10","series-title":"J Clin Med","first-page":"1711","article-title":"CSF dynamics for shunt prognostication and revision in normal pressure hydrocephalus","volume":"10","author":"Lalou AD","year":"2021","unstructured":"Lalou AD, Czosnyka M, Placek MM, Smielewski P, Nabbanja E, Czosnyka Z. CSF dynamics for shunt prognostication and revision in normal pressure hydrocephalus. J Clin Med. 2021;10(8):1711."},{"issue":"1","key":"b11","series-title":"J Neurosurg","first-page":"130","article-title":"Increase in callosal angle and decrease in ventricular volume after shunt surgery in patients with idiopathic normal pressure hydrocephalus","volume":"130","author":"Virhammar J","year":"2018","unstructured":"Virhammar J, Laurell K, Cesarini KG, Larsson EM. Increase in callosal angle and decrease in ventricular volume after shunt surgery in patients with idiopathic normal pressure hydrocephalus. J Neurosurg. 2018;130(1):130\u2013135."},{"issue":"4","key":"b12","series-title":"J Neuroradiol","first-page":"312","article-title":"Ventricular volumetry and free-water corrected diffusion tensor imaging of the anterior thalamic radiation in idiopathic normal pressure hydrocephalus","volume":"47","author":"Saito A","year":"2020","unstructured":"Saito A, Kamagata K, Ueda R,  Ventricular volumetry and free-water corrected diffusion tensor imaging of the anterior thalamic radiation in idiopathic normal pressure hydrocephalus. J Neuroradiol. 2020;47(4):312\u2013317."},{"issue":"1-2","key":"b13","series-title":"J Neurol Sci","first-page":"7","article-title":"Changes in the volumes of the brain and cerebrospinal fluid spaces after shunt surgery in idiopathic normal-pressure hydrocephalus","volume":"296","author":"Hiraoka K","year":"2010","unstructured":"Hiraoka K, Yamasaki H, Takagi M,  Changes in the volumes of the brain and cerebrospinal fluid spaces after shunt surgery in idiopathic normal-pressure hydrocephalus. J Neurol Sci. 2010;296(1-2):7\u201312."},{"issue":"1","key":"b14","series-title":"Sci Rep","first-page":"17318","article-title":"Longitudinal morphological changes during recovery from brain deformation due to idiopathic normal pressure hydrocephalus after ventriculoperitoneal shunt surgery","volume":"9","author":"Yamada S","year":"2019","unstructured":"Yamada S, Ishikawa M, Yamaguchi M, Yamamoto K. Longitudinal morphological changes during recovery from brain deformation due to idiopathic normal pressure hydrocephalus after ventriculoperitoneal shunt surgery. Sci Rep. 2019;9(1):17318."},{"issue":"1","key":"b15","series-title":"Neurosurg Rev","first-page":"503","article-title":"Structural volumetry in NPH diagnostics and treatment-future or dead end?","volume":"44","author":"Vlas\u00e1k A","year":"2021","unstructured":"Vlas\u00e1k A, Skalick\u00fd P, Ml\u00e1dek A, Vr\u00e1na J, Bene\u0161 V, Brad\u00e1\u010d O. Structural volumetry in NPH diagnostics and treatment-future or dead end? Neurosurg Rev. 2021;44(1):503\u2013514."},{"issue":"12","key":"b16","series-title":"AJNR Am J Neuroradiol","first-page":"2165","article-title":"Changes in ventricular and cortical volumes following shunt placement in patients with idiopathic normal pressure hydrocephalus","volume":"42","author":"Cogswell PM","year":"2021","unstructured":"Cogswell PM, Murphy MC, Senjem ML,  Changes in ventricular and cortical volumes following shunt placement in patients with idiopathic normal pressure hydrocephalus. AJNR Am J Neuroradiol. 2021;42(12):2165\u20132171."},{"issue":"7","key":"b17","series-title":"AJNR Am J Neuroradiol","first-page":"1187","article-title":"Ventricular volume is more strongly associated with clinical improvement than the Evans index after shunting in idiopathic normal pressure hydrocephalus","volume":"41","author":"Neikter J","year":"2020","unstructured":"Neikter J, Agerskov S, Hellstr\u00f6m P,  Ventricular volume is more strongly associated with clinical improvement than the Evans index after shunting in idiopathic normal pressure hydrocephalus. AJNR Am J Neuroradiol. 2020;41(7):1187\u20131192."},{"issue":"5","key":"b18","series-title":"AJNR Am J Neuroradiol","first-page":"797","article-title":"Quantitative MRI for rapid and user-independent monitoring of intracranial CSF volume in hydrocephalus","volume":"37","author":"Virhammar J","year":"2016","unstructured":"Virhammar J, Warntjes M, Laurell K, Larsson EM. Quantitative MRI for rapid and user-independent monitoring of intracranial CSF volume in hydrocephalus. AJNR Am J Neuroradiol. 2016;37(5):797\u2013801."},{"issue":"10","key":"b19","series-title":"J Neurol","first-page":"1994","article-title":"Differentiating shunt-responsive normal pressure hydrocephalus from Alzheimer disease and normal aging: pilot study using automated MRI brain tissue segmentation","volume":"261","author":"Serulle Y","year":"2014","unstructured":"Serulle Y, Rusinek H, Kirov II,  Differentiating shunt-responsive normal pressure hydrocephalus from Alzheimer disease and normal aging: pilot study using automated MRI brain tissue segmentation. J Neurol. 2014;261(10):1994\u20132002."},{"issue":"8","key":"b20","series-title":"Mov Disord","first-page":"1406","article-title":"Magnetic resonance imaging biomarkers distinguish normal pressure hydrocephalus from progressive supranuclear palsy","volume":"35","author":"Quattrone A","year":"2020","unstructured":"Quattrone A, Sarica A, La Torre D,  Magnetic resonance imaging biomarkers distinguish normal pressure hydrocephalus from progressive supranuclear palsy. Mov Disord. 2020;35(8):1406\u20131415."},{"key":"b21","series-title":"Front Aging Neurosci","first-page":"584842","article-title":"Idiopathic normal pressure hydrocephalus and elderly acquired hydrocephalus: evaluation with cerebrospinal fluid flow and ventricular volume parameters","volume":"12","author":"He WJ","year":"2020","unstructured":"He WJ, Zhou X, Long J,  Idiopathic normal pressure hydrocephalus and elderly acquired hydrocephalus: evaluation with cerebrospinal fluid flow and ventricular volume parameters. Front Aging Neurosci. 2020;12:584842."},{"issue":"3","key":"b22","series-title":"Neurosurgery","first-page":"582","article-title":"Decreases in ventricular volume correlate with decreases in ventricular pressure in idiopathic normal pressure hydrocephalus patients who experienced clinical improvement after implantation with adjustable valve shunts","volume":"55","author":"McConnell KA","year":"2004","unstructured":"McConnell KA, Zou KH, Chabrerie AV, Bailey NO, Black PM. Decreases in ventricular volume correlate with decreases in ventricular pressure in idiopathic normal pressure hydrocephalus patients who experienced clinical improvement after implantation with adjustable valve shunts. Neurosurgery. 2004;55(3):582\u2013593."},{"key":"b23","series-title":"BMJ","first-page":"c332","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz KF","year":"2010","unstructured":"Schulz KF, Altman DG, Moher D.. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332."},{"issue":"4","key":"b24","series-title":"PLoS One","first-page":"e0232275","article-title":"Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus","volume":"15","author":"Kockum K","year":"2020","unstructured":"Kockum K, Virhammar J, Riklund K, S\u00f6derstr\u00f6m L, Larsson EM, Laurell K. Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus. PLoS One. 2020;15(4):e0232275."},{"issue":"12","key":"b25","series-title":"AJNR Am J Neuroradiol","first-page":"2311","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. 2014;35(12):2311\u20132318."},{"issue":"1","key":"b26","series-title":"Fluids Barriers CNS","first-page":"59","article-title":"Ventricular volume in relation to lumbar CSF levels of amyloid-\u03b2 1-42, tau and phosphorylated tau in iNPH, is there a dilution effect?","volume":"19","author":"Lid\u00e9n S","year":"2022","unstructured":"Lid\u00e9n S, Farahmand D, Laurell K. Ventricular volume in relation to lumbar CSF levels of amyloid-\u03b2 1-42, tau and phosphorylated tau in iNPH, is there a dilution effect? Fluids Barriers CNS. 2022;19(1):59."},{"issue":"1","key":"b27","series-title":"Acta Neurol Scand","first-page":"38","article-title":"An adjustable CSF shunt: advices for clinical use","volume":"108","author":"Lundkvist B","year":"2003","unstructured":"Lundkvist B, Eklund A, Koskinen LO, Malm J. An adjustable CSF shunt: advices for clinical use. Acta Neurol Scand. 2003;108(1):38\u201342."},{"issue":"7","key":"b28","series-title":"J Neurol Neurosurg Psychiatry","first-page":"813","article-title":"A randomised trial of high and low pressure level settings on an adjustable ventriculoperitoneal shunt valve for idiopathic normal pressure hydrocephalus: results of the Dutch evaluation programme Strata shunt (DEPSS) trial","volume":"84","author":"Delwel EJ","year":"2013","unstructured":"Delwel EJ, de Jong DA, Dammers R, Kurt E, van den Brink W, Dirven CM. A randomised trial of high and low pressure level settings on an adjustable ventriculoperitoneal shunt valve for idiopathic normal pressure hydrocephalus: results of the Dutch evaluation programme Strata shunt (DEPSS) trial. J Neurol Neurosurg Psychiatry. 2013;84(7):813\u2013817."},{"issue":"5","key":"b29","series-title":"J Neurosurg","first-page":"1257","article-title":"A randomized controlled dual-center trial on shunt complications in idiopathic normal-pressure hydrocephalus treated with gradually reduced or \"fixed\" pressure valve settings","volume":"121","author":"S\u00e6hle T","year":"2014","unstructured":"S\u00e6hle T, Farahmand D, Eide PK, Tisell M, Wikkels\u00f6 C. A randomized controlled dual-center trial on shunt complications in idiopathic normal-pressure hydrocephalus treated with gradually reduced or \"fixed\" pressure valve settings. J Neurosurg. 2014;121(5):1257\u20131263."},{"issue":"2","key":"b30","series-title":"Magn Reson Med","first-page":"320","article-title":"Rapid magnetic resonance quantification on the brain: optimization for clinical usage","volume":"60","author":"Warntjes JB","year":"2008","unstructured":"Warntjes JB, Leinhard OD, West J, Lundberg P. Rapid magnetic resonance quantification on the brain: optimization for clinical usage. Magn Reson Med. 2008;60(2):320\u2013329."},{"issue":"2","key":"b31","series-title":"Behav Res Methods","first-page":"175","article-title":"G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul F","year":"2007","unstructured":"Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175\u2013191."},{"issue":"2","key":"b32","series-title":"Stat Methods Med Res","first-page":"135","article-title":"Measuring agreement in method comparison studies","volume":"8","author":"Bland JM","year":"1999","unstructured":"Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135\u2013160."},{"issue":"1","key":"b33","series-title":"J Stat Softw","first-page":"1","article-title":"Fitting linear mixed-effects models using lme4","volume":"67","author":"Bates D","year":"2015","unstructured":"Bates D, M\u00e4chler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67(1):1\u201348."},{"issue":"1","key":"b34","series-title":"Neuroimage","first-page":"177","article-title":"MRI-derived measurements of human subcortical, ventricular and intracranial brain volumes: reliability effects of scan sessions, acquisition sequences, data analyses, scanner upgrade, scanner vendors and field strengths","volume":"46","author":"Jovicich J","year":"2009","unstructured":"Jovicich J, Czanner S, Han X,  MRI-derived measurements of human subcortical, ventricular and intracranial brain volumes: reliability effects of scan sessions, acquisition sequences, data analyses, scanner upgrade, scanner vendors and field strengths. Neuroimage. 2009;46(1):177\u2013192."},{"key":"b35","series-title":"J Clin Neurosci","first-page":"141","article-title":"The diagnosis of ventriculoperitoneal shunt malfunction by using phase-contrast cine magnetic resonance imaging","volume":"64","author":"Zhang H","year":"2019","unstructured":"Zhang H, Zhang J, Peng J, Hao X, Li G. The diagnosis of ventriculoperitoneal shunt malfunction by using phase-contrast cine magnetic resonance imaging. J Clin Neurosci. 2019;64:141\u2013144."},{"issue":"6","key":"b36","series-title":"J Neuroimaging","first-page":"746","article-title":"Phase-contrast MRI detection of ventricular shunt CSF flow: proof of principle","volume":"30","author":"K\u00f6nig RE","year":"2020","unstructured":"K\u00f6nig RE, Stucht D, Baecke S,  Phase-contrast MRI detection of ventricular shunt CSF flow: proof of principle. J Neuroimaging. 2020;30(6):746\u2013753."},{"issue":"5","key":"b37","series-title":"Neurosurgery","first-page":"939","article-title":"Diagnostic accuracy of non-invasive thermal evaluation of ventriculoperitoneal shunt flow in shunt malfunction: a prospective, multi-site, operator-blinded study","volume":"87","author":"Madsen JR","year":"2020","unstructured":"Madsen JR, Boyle TP, Neuman MI,  Diagnostic accuracy of non-invasive thermal evaluation of ventriculoperitoneal shunt flow in shunt malfunction: a prospective, multi-site, operator-blinded study. Neurosurgery. 2020;87(5):939\u2013948."},{"key":"b38","series-title":"Surg Neurol Int","first-page":"254","article-title":"Noninvasive thermal evaluation for shunt failure in the emergency room","volume":"10","author":"Xu J","year":"2019","unstructured":"Xu J, Poole C, Sahyouni R, Chen J. Noninvasive thermal evaluation for shunt failure in the emergency room. Surg Neurol Int. 2019;10:254."},{"issue":"2","key":"b39","series-title":"J Neurosurg","first-page":"668","article-title":"Risk factors for developing subdural hematoma: a registry-based study in 1457 patients with shunted idiopathic normal pressure hydrocephalus","volume":"134","author":"Gasslander J","year":"2021","unstructured":"Gasslander J, Sundstr\u00f6m N, Eklund A, Koskinen LD, Malm J. Risk factors for developing subdural hematoma: a registry-based study in 1457 patients with shunted idiopathic normal pressure hydrocephalus. J Neurosurg. 2021;134(2):668\u2013677."},{"issue":"2","key":"b40","series-title":"Acta Neurochir (Wien)","first-page":"257","article-title":"The lack of relationship between intracranial pressure and cerebral ventricle indices based on brain computed tomography in patients undergoing ventriculoperitoneal shunt","volume":"157","author":"Kim E","year":"2015","unstructured":"Kim E, Lim YJ, Park HS,  The lack of relationship between intracranial pressure and cerebral ventricle indices based on brain computed tomography in patients undergoing ventriculoperitoneal shunt. Acta Neurochir (Wien). 2015;157(2):257\u2013263."},{"issue":"1","key":"b41","series-title":"Br J Neurosurg","first-page":"21","article-title":"Incidence and outcome of surgery for adult hydrocephalus patients in Sweden","volume":"31","author":"Sundstr\u00f6m N","year":"2017","unstructured":"Sundstr\u00f6m N, Malm J, Laurell K,  Incidence and outcome of surgery for adult hydrocephalus patients in Sweden. Br J Neurosurg. 2017;31(1):21\u201327."},{"issue":"10","key":"b42","series-title":"Acta Neurochir (Wien)","first-page":"1977","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). 2013;155(10):1977\u20131980."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/5\/article-p1493.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/5\/article-p1493.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/5\/article-p1493.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T10:24:08Z","timestamp":1716632648000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/5\/article-p1493.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":42,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2023.9.jns23668","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,1]]}}}