Idiopathic normal pressure hydrocephalus | ―Indications and timing for shunt therapy intervention, and medical economic effects

Idiopathic normal pressure hydrocephalus
―Indications and timing for shunt therapy intervention, and medical economic effects

Madoka Nakajima

Department of Neurosurgery, Juntendo University School of Medicine

In the process of advancing to a super-aging society in Japan, more and more attention is dedicated to the idiopathic normal pressure hydrocephalus (iNPH) as a disease specific for the elderly. The treatment tendency in Japan is application of the minimally invasive lumbo-peritoneal shunting with results comparable to the ventriculo-peritoneal type as reportedin the multicenter prospective randomized trial. From socio-economic point of view, shunt intervention effect on the patient care expenses shows reduction after 18 to 21 months of surgical treatment with grade 1 level of evdence (Laupacis criteria). Estimating from the epidemiological survey that 1.1% of those at or above 65 in Japan have iNPH diagnostic imaging criteria, the hospital-based finding of prevalence of 10.2/100,000 indicates that only a small part of the iNPH patient population is benefiting from management at the moment.

Address correspondence to Dr. Madoka Nakajima, Department of Neurosurgery, Juntendo University School of Medicine (2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan)