Idiopathic normal pressure hydrocephalus: a contemporary guide
Practical Neurology Podcast
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Can Radiology Be Used to Predict MPH?
The Japanese hydrocephalus guidelines changed, and Madoka Nakajima published those the year before last. And they updated them to say that if you have very specific clinical features in a specific scan, and provided the LP didn't show anything abnormal, you could proceed just to shunting. Whereas if the scan was less specific, then you needed more provocative tests. So I don't know many neurosurgeons would be happy to do a shunt without some evidence that the patient's going to improve from it. But most people I speak to certainly in the UK want some evidence that there's going to be improvement.
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