Chronic Adult Hydrocephalus
Conditions
Keywords
Computerised gait analysis, Ultrasound measurement of cerebral pulsatility, MRI flow, Urinary incontinence scale, Subtractive lumbar puncture
Brief summary
Idiopathic chronic adult hydrocephalus (ICAH) is due to expansion of the fluid-filled cavities in the brain. The clinical symptoms are gait disturbance, mental decline and incontinence. Treatment involves installing a ventriculoperitoneal shunt which is known to be able to induce regression of the symptoms in many cases meaning that ICAH is a classic, curable cause of dementia. Diagnosis relies on comparing symptoms before and after depleting cerebrospinal fluid (CSF) via a lumbar puncture (LP). In practice, the situation is complicated: improvement is often incomplete and there is no consensus on either how to assess the symptoms or how they change after CSF depletion. In consequence, the decision whether not to undertake surgery often depends on the neurosurgeon's clinical impression. Over recent years, the cognitive profile of patients with ICAH has become better characterised and reproducible, objective techniques have been developed to assess motor function and CSF flow in the brain. The investigators project aims to define the value of these new investigative techniques in the positive diagnosis of ICAH, in comparison to current decision-making tools.
Interventions
OTHERDiagnosis of ICAH using new investigative techniques (computerised gait analysis, ultrasound, MRI flow, urinary incontinence scale)
Diagnosis of ICAH using new investigative techniques (computerised gait analysis, ultrasound, MRI flow, urinary incontinence scale)
Sponsors
University Hospital, Tours
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult 65 years or older * Hospitalized patients (at the University Hospital of Tours) requiring the assessment of chronic hydrocephalus in adults, suspected clinically * Patient undergoing Lumbar Puncture subtractive * Informed consent form signed * Affiliated to a medical insurance
Exclusion criteria
* Contraindications to MRI * Inability to walk or to stand before having lumbar puncture * Patient under trusteeship and guardianship, or judicial protection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cerebrospinal fluid biomarkers of degeneration from Alzheimer's disease. | 5 days | Association between the decision-making with regard to permanent CSF shunt and the response to subtractive lumbar puncture |
| Computerised gait analysis | 5 days | Association between the decision-making with regard to permanent CSF shunt and the Computerised gait analysis, |
| Ultrasound measurement of cerebral pulsatility | 5 days | Association between the decision-making with regard to permanent CSF shunt and the Ultrasound measurement of cerebral pulsatility, |
| Qualitative and quantitative analysis (average speed and flow) of the hydrodynamic characteristics of the cerebrospinal fluid. | 5 days | Association between the decision-making with regard to permanent CSF shunt and the MRI flow, |
| Urinary incontinence | 5 days | Association between the decision-making with regard to permanent CSF shunt and the Urinary incontinence scale |
Countries
France
Outcome results
None listed