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Can preoperative brain imaging features predict shunt response in idiopathic normal pressure hydrocephalus? A PRISMA review

  • Diagnostic Neuroradiology
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Abstract

Purpose

This systematic literature review aimed to identify brain computed tomography (CT) and magnetic resonance imaging (MRI) features that could be used to discriminate idiopathic normal pressure hydrocephalus (iNPH) shunt responders from non-responders.

Methods

PubMed, Embase, Web of Science, and Cochrane were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only original research articles reporting preoperative CT and/or MRI features and iNPH shunt response evaluated by changes in gait, dementia, and urinary incontinence were included. Title and abstract screening and full-text article evaluation were done by two authors. Data on patient demographics and inclusion criteria, brain image evaluation, shunting methods, and shunt response evaluation were recorded.

Results

The search resulted in 1274 studies after removing duplicates. Twenty-seven studies were chosen for final review. Both structural (i.e., callosal angle, disproportionately enlarged subarachnoid space hydrocephalus (DESH), and temporal horn diameter) and physiological brain imaging (including aqueductal flow measurement and brain perfusion) had been examined. Fourteen out of 27 studies found no difference in any assessed imaging parameters between responders and non-responders, and none of the examined imaging parameters was repeatedly and consistently reported as significantly different between the two groups.

Conclusions

No brain imaging parameters were consistently and repeatedly reported as different between iNPH shunt responders and non-responders.

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Authors and Affiliations

  1. Dept. of Radiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Jonathan Frederik Carlsen, Adam Espe Hansen & Alexander Malcolm Rykkje

  2. Dept. of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Jonathan Frederik Carlsen, Tina Nørgaard Munch & Adam Espe Hansen

  3. Dept. of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Tina Nørgaard Munch

  4. Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

    Tina Nørgaard Munch

  5. Danish Dementia Research Centre, Dept. of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    Steen Gregers Hasselbalch

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  1. Jonathan Frederik Carlsen
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Correspondence to Jonathan Frederik Carlsen.

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Carlsen, J.F., Munch, T.N., Hansen, A.E. et al. Can preoperative brain imaging features predict shunt response in idiopathic normal pressure hydrocephalus? A PRISMA review. Neuroradiology 64, 2119–2133 (2022). https://doi.org/10.1007/s00234-022-03021-9

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