Diagnosis and treatment in hydrocephalus related reversible senile dementia

Junji Wei, PhD, Jing Gao, PhD, Feng Feng, PhD, Caiyan Liu, PhD, Yi Wang, PhD, Huan Chen, PhD, Peking Union Medical College Hospital

Dementia is a common cognitive disorder in the elderly population. One of its important causes is normal pressure hydrocephalus (NPH), which features a clinical triad of gait disturbance, cognitive impairment and urinary incontinence, but with a normal intracranial pressure. For patients who have not been diagnosed or properly treated, the condition can gradually progress, leading to worsening of the dementia, paralysis or even death, which will place a heavy burden to not only the family but also the society. For many years, neurologists lacked the knowledge and research on the cognitive impairment caused by NPH and its surgical feasibility. we establish a multidisciplinary NPH research team. The research team conducted clinical and imaging screening of normal pressure hydrocephalus patients and carried out the corresponding epidemiological investigations. Suspected patients were evaluated and analyzed using cerebrospinal fluid tap test. Once NPH was diagnosed, ventricular-peritoneal shunt or lumbar-peritoneal shunt will be performed with follow-up after the surgery. We obtained the epidemiological data, found potential biomarkers in peripheral blood and cerebrospinal fluid and established a standardized evaluation system for NPH patients with standardized surgical treatment procedures.