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The tests have a positive predictive value over 90%, but a negative predictive value less than 50%. The LP should show normal or mildly elevated CSF pressure. CSF should have normal cell contents, glucose levels, and protein levels. [25] [26] [27]
The CSF tap test, sometimes lumbar tap test or Miller Fisher Test, is a medical test that is used to decide whether shunting of cerebrospinal fluid (CSF) would be helpful in a patient with suspected normal pressure hydrocephalus (NPH). The test involves removing 30–50 ml of CSF through a lumbar puncture, after which motor and cognitive ...
In the setting of raised pressure (or normal pressure hydrocephalus, where the pressure is normal but there is excessive CSF), lumbar puncture may be therapeutic. [27] Decreased CSF pressure can indicate complete subarachnoid blockage, leakage of spinal fluid, severe dehydration, hyperosmolality, or circulatory collapse. Significant changes in ...
The four types of hydrocephalus are communicating, noncommunicating, ex vacuo, and normal pressure. Diagnosis is typically made by physical examination and medical imaging. [1] Hydrocephalus is typically treated by the surgical placement of a shunt system. [1] A procedure called a third ventriculostomy is an option in some people. [1]
A test for assessing shunt function in symptomatic hydrocephalus patients. ShuntCheck flow data, used in conjunction with other diagnostic test results and with physician judgment, can aid in ruling in or ruling out shunt obstruction. [1] A tool for establishing “normal” CSF flow patterns in asymptomatic patients.
Normal pressure hydrocephalus (NPH) looks at CSF flow values and velocities, which is important for diagnosis because NPH is idiopathic and has varying symptoms amongst patients including urinary incontinence, dementia, and gait disturbances. Increased aqueduct CSF stroke volume and velocity are indicators of NPH. [7]
The diagnosis is based on symptoms and a high opening pressure found during a lumbar puncture with no specific cause found on a brain scan. [1] [2] Treatment includes a healthy diet, salt restriction, and exercise. [2] The medication acetazolamide may also be used along with the above measures. [2]
When a patient has communicating hydrocephalus, the lateral ventricles and medial parts of the temporal lobes expand and compress the aqueduct. As a result, the pressure within the fourth ventricle drops and causes the aqueduct to close more tightly. This in effect could make aqueductal stenosis a byproduct of hydrocephalus. [8]