Background. The normal pressure hydrocephalus syndrome (NPH) is characterized by the presence of a clinical
triad comprising dementia, motor apraxia, and sphincter complaint, along with the presence of distinct dilatation of
the ventricular systemin the absence ofmajor cortical atrophy. The diagnosis of NPH must be confirmed by including
dynamic liquor tests into the algorithm of examination. The lumbar infusion test (LIT) represents the „gold standard“
of liquor dynamic tests.
Methods and Results. The authors present 24 patients in a prospective managed study. Indication of shunt surgery
was based on the result of LIT.At the time of assessment of the diagnosis 28%of the patients were greatly dependent
on the nursing care; after the shunt implantation only 7 % were still greatly dependent. Shunt implantation brought
about increased percentage of patients who were evaluated as quite independent (rise from 14 % to 64 %). Control
group consists of 10 patients with negative LITre sults; there were no changes in evaluated parameters in this group.
The coincidence of cerebrovascular diseases is probably the most common reason of nonresponsibility to shunt
implantation in LITpos itive patients.
Conclusions. In the presented study authors tried to evaluate the possibility of transcranial dopplerometry (TCD)
for evaluation of the role of cerebrovascular diseases in the clinical picture of the LITpos itive patients in order to
diminish the unsatisfactory clinical results of shunt implantation. The presented study is the largest one in our country,
which is focused on these problems.
normotensive hydrocephalus, lumbar infusion test, shunt, transcranial dopplerometry.