RESUMO
Objective To describe the natural history and shunt outcome in patients with normal pressure hydrocephalus (NPH) and the variables that influence both. Method Motor and cognitive parameters of 35 patients with NPH, as well as shunt surgery status, were registered at two time points (T0 and T1). Results Thirteen patients underwent shunt surgery. Favorable outcome in gait function occurred in 5 of 35 patients and was related to younger age, absence of cardiovascular risk factors (CVRF) and white matter lesions (WML), and shunt surgery. Cognitive outcome was favorable in 9 of 35 patients and associated with shunt surgery (trend level). Of the patients subjected to surgery, favorable outcome in motor function was related to younger age at T0 and absence of CVRF and WML (trend level). Conclusion Shunt surgery had a significant effect on gait and less on cognition. Favorable outcome in gait was also associated with younger age and absence of CVRF and WML. .
Objetivo Descrever a história natural e o prognóstico após cirurgia de derivação ventricular em doentes com hidrocefalia de pressão normal (HPN), e as variáveis que potencialmente os influenciam. Método Foram registados os parâmetros motores e cognitivos de 35 doentes com HPN, assim como o status relativo a cirurgia, em dois pontos no tempo (T0 e T1). Resultados Treze doentes foram submetidos a cirurgia. Melhoria na marcha ocorreu em 5 doentes e relacionou-se com idade mais jovem, ausência de factores de risco cardio-vascular (FRCV), ausência de lesões da substância branca (LSB) e colocação de derivação ventricular. Verificou-se melhoria cognitiva em 9 doentes, associada (p=0,05) com colocação de derivação ventricular. Em doentes submetidos a cirurgia, o prognóstico favorável a nível motor relacionou-se com idade mais jovem em T0, ausência de FRCV e de LSB. Conclusão A cirurgia para colocação de derivação ventricular teve um efeito significativo sobre a marcha e menor na cognição. O prognóstico favorável na marcha parece também associar-se a idade mais jovem, a ausência de FRV e de LSB. .
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cognição/fisiologia , Hidrocefalia de Pressão Normal/cirurgia , Derivação Ventriculoperitoneal/reabilitação , Fatores Etários , Transtornos Neurológicos da Marcha/fisiopatologia , Hidrocefalia de Pressão Normal/fisiopatologia , Prognóstico , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
OBJECTIVE: To describe the natural history and shunt outcome in patients with normal pressure hydrocephalus (NPH) and the variables that influence both. METHOD: Motor and cognitive parameters of 35 patients with NPH, as well as shunt surgery status, were registered at two time points (T0 and T1). RESULTS: Thirteen patients underwent shunt surgery. Favorable outcome in gait function occurred in 5 of 35 patients and was related to younger age, absence of cardiovascular risk factors (CVRF) and white matter lesions (WML), and shunt surgery. Cognitive outcome was favorable in 9 of 35 patients and associated with shunt surgery (trend level). Of the patients subjected to surgery, favorable outcome in motor function was related to younger age at T0 and absence of CVRF and WML (trend level). CONCLUSION: Shunt surgery had a significant effect on gait and less on cognition. Favorable outcome in gait was also associated with younger age and absence of CVRF and WML.