PATHOPHYSIOLOGY, SIGNS, SYMPTOMS AND COUR SE OF DISEASE IN NORMAL-PRESSURE HYDROCEPHALUS

Between May 1982 until January 1997 we investigated 200 patients suspe cted for normal pressure hydrocephalus (NPH) by performing an intrathe cal infusion test. According to our experiences gait ataxia is the lea ding symptom of NPH. Regarding dementia we could not find a significan t difference compared to cerebral atrophy. Bladder incontinence can be characterised as a symptom of late-stage NPH. The complete Hakim tria s should not be overestimated in differential diagnostic consideration s. Graduation of NPH and cerebral atrophy after the results of the inf usion test in an early and late stage enables prognostic evaluation of the course of disease. Patients with NPH in an early stage report in the follow-up on an improvement of their symptoms after shunt operatio n (65 percent of patients), whereas 50 percent of the patients with la te stage NPH were improved. The computer-aided infusion test allows se cure differentiation between patients with NPH and those with cerebral atrophy.