[The lumbar infusion test and transcranial Doppler ultrasonography in the diagnosis and treatment of normotensive hydrocephalus. Prospective evaluation of a group of patients from 2000 to 2002].

BACKGROUND: The normal pressure hydrocephalus syndrome (NPH) is characterized by the presence of a clinical triad comprising dementia, motor apraxia, and sphincter complaint, along with the presence of distinct dilatation of the ventricular system in the absence of major cortical atrophy. The diagnosis of NPH must be confirmed by including dynamic liquor tests into the algorithm of examination. The lumbar infusion test (LIT) represents the "gold standard" of liquor dynamic tests.

METHODS AND RESULTS: The authors present 24 patients in a prospective managed study. Indication of shunt surgery was based on the result of LIT. At the time of assessment of the diagnosis 28% of the patients were greatly dependent on the nursing care; after the shunt implantation only 7% were still greatly dependent. Shunt implantation brought about increased percentage of patients who were evaluated as quite independent (rise from 14% to 64%). Control group consists of 10 patients with negative LIT results; there were no changes in evaluated parameters in this group. The coincidence of cerebrovascular diseases is probably the most common reason of nonresponsibility to shunt implantation in LIT positive patients.