Aim. To find out a practical neuropsychological tool for early and reliable outcome assessment in chronic hydrocephalus. In 30 patients (65 ± 13 yrs.) 11 neuropsychological tests providing a wide range of psychomotor functions (visual and verbal attention, verbal memory and learning and visuomotor skills) were applied before (pre), one week (early) and 7 months (late) after shunting. After 7 months, clinical outcome was classified according to Stein and Langfitt. Statistics included factor analysis, logistic regression and non-parametric tests. Visual attention ("Digit-symbol"), verbal recall ("10-words-list") and motor precision ("line-tracing") were the most representative (and practical) tests (orthogonal loads > 0.9). These tests, in contrast to others, revealed significant differences between outcome groups concerning early postoperative changes: responder showed marked improvement in visual attention t-scores (47 ± 8 vs. 41 ± 8 (pre); p = 0.005) and motor precision scores (109 ± 26 vs. 149 ± 47 (pre); p = 0.03). Non-responder even decreased in verbal recall t-scores early after shunting (35 ± 7 vs. 41 ± 11 (pre); p = 0.007). By logistic regression, visual attention was most sensitive indicating shunt-response by early psychometric changes (p = 0.04). Psychomotor deficits in hydrocephalic patients can be represented by a few neuropsychological skills: visual attention, verbal recall and line tracing. Since they showed early post-operative differences regarding long-term response to shunting they may offer a practical and standardised method for reliable follow-up. © Springer-Verlag 2002.
CITATION STYLE
Klinge, P., Ruückert, N., Schuhmann, M., Dörner, L., Brinker, T., & Samii, M. (2002). Neuropsychological testing to improve surgical management of patients with chronic hydrocephalus after shunt treatment. Acta Neurochirurgica, Supplement, 81, 51–53. https://doi.org/10.1007/978-3-7091-6738-0_13
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