The predictive value of cerebrospinal fluid tap-test in normal pressure hydrocephalus

Eighteen patients (mean age of 66.5 years) with normal pressure hydrocephalus (NPH) underwent a ventriculo-peritoneal shunt surgery. Prior to operation a cerebrospinal fluid tap-test (CS F-TT) was performed with measurements of gait pattern and psychometric functions (memory, visuo-motor speed and visuo-constructive skills) before and af ter the removal of 50 ml CSF by lumbar puncture (LP). Fifteen patients improved and 3 were unchanged after surgery. Short duration of disease, gait disturbance preceding mental deterioration, wide temporal hems and small sulci on CT-scan were associated with good outcome after shunting. That was a good correlation between the results of CSF-TT and shunt surgery (X-2 = 4,11,phi = 0.48, p < 0.05), with gait test showing highest correlation (r = 0.99, p = 0.01). In conclusion, this version of CSF-TT proved to be an effective rest to predict improvement after shunting in patients with NPH.