The diagnosis and surgical treatment of normal-pressure hydrocephalus

Johnson, Michelle MSBS, PA-C; Graham, Karen MPAS, PA-C

Michelle Johnson practices in trauma and general surgery at The Toledo Hospital, Ohio. Ms Johnson was a student in the PA program at the University of Toledo, Ohio, when this article was written. Karen Graham was Assistant Professor in the program and practiced clinically at the University of Toledo Medical Center, Center for Neurological Disorders, Toledo, Ohio, when this article was written. The authors have indicated no relationships to disclose relating to the content of this article.

JAAPA 23(5):p 51-56, May 2010.

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Abstract

LEARNING OBJECTIVES

Discuss the clinical presentation of normal-pressure hydrocephalus (NPH) and how it is diagnosed
Describe how patients with NPH are selected for ventriculoperitoneal (VP) shunt surgery
Explain the surgical complications and prognosis associated with VP shunt surgery
Discuss the management of patients who do not improve after VP shunt insertion

EARN CATEGORY I CME CREDIT by reading this article and the article beginning on page 22 and successfully completing the posttest on page 57. Successful completion is defined as a cumulative score of at least 70% correct. This material has been reviewed and is approved for 1 hour of clinical Category I (Preapproved) CME credit by the AAPA. The term of approval is for 1 year from the publication date of May 2010.

NPH is characterized by gait difficulty, cognitive impairment, and urinary incontinence. For some patients, ventriculoperitoneal shunt surgery offers dramatic improvement.