Mukhtar Ahmad, Azam Niaz, Samra Majeed, Anjum Habib Vohra, Hamza Bokhari.
Normal Pressure Hydrocephalus: Selection of patients for Shunt Placement.
Pak J Neuro Surg Jan ;18(2):145-8.

Objective: To determine the criteria in our setup, for patients with normal pressure hydrocephalus (NPH), based on clinical and radiological findings.Material and Methods: This is multiple center study, including departments of Neurosurgery at LGH, Lahore / KEMU, Lahore. Over 25 years, 240 patients were included purely on clinical criteria of poor memory, sphincter loss, gait apraxia and Evan’s ratio ≥ 0.30 on CT or MRI. All patients had shunting procedures.Results: Hundred and ninety patients were improved and all of them had significant reduction in Evan’s ratio i.e. ≥ 0.06. Only 10 patients had infection out of whom 8 lost to follow up while 2 had shunt revision.Conclusion: Shunting procedures especially VP shunt shows good results if selection is stringent and no co-morbidity is associated.

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