臨床神経学

第48回日本神経学会総会

<シンポジウム10-1>機能回復神経学
特発性正常圧水頭症

森 悦朗

東北大学大学院医学系研究科 高次機能障害学〔〒980-8575 仙台市青葉区星陵町2-1〕

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by gait disturbance, dementia, and/or urinary incontinence without causative disorders, and ventricular enlargement due to disturbed CSF circulation. The diagnosis of iNPH in the elderly remains a substantial issue, and the treatment is not always adequately provided. Many patients with possibly curable INPH often are misdiagnosed as having AD or vascular dementia. Recognition of INPH in those patients is of great importance. Here, some key clinical and neuroimaging features distinctive from other dementia are discussed. Also reviewed are the results of the recently completed prospective cohort study of iNPH (Study of iNPH on Neurological Improvement: SINPHONI). In SINPHONI, the MRI-based diagnosis (dilated ventricles associated with narrow dorsal subarrachnoid space) and ventriculoperitoneal shunt with Codman Hakim programmable valve shunt system were validated against 1-year post-surgery outcome.

(臨床神経, 47:945−947, 2007)
key words:特発性正常圧水頭症, 診断, 神経学, MRI, 臨床試験

(受付日:2007年5月16日)