Evidenzbasierte Therapie des idiopathischen Normaldruckhydrozephalus

Zusammenfassung

Die klinische Forschung zum idiopathischen Normaldruckhydrozephalus erfolgt auf steigendem methodischem Niveau und ermöglicht die evidenzbasierte Therapie der Patienten. Die jährliche Inzidenz von Patienten mit einem diagnostizierten und therapierten idiopathischen Normaldruckhydrozephalus beträgt in den westlichen Ländern nach epidemiologischen Untersuchungen ca. 1/100 000 Einwohner. Non-invasive Methoden spielen in der Diagnostik eine zunehmend wichtigere Rolle, können allerdings die invasiven Methoden noch nicht ersetzen. Die grundsätzliche Effektivität von Liquorshunts zur Therapie des idiopathischen Normaldruckhydrozephalus konnte nachgewiesen werden. In weiteren Untersuchungen konnte gezeigt werden, dass die Komplikationsrate durch die Implantation von programmierbaren Ventilen mit Gravitationsventilen deutlich minimiert wird. Programmierbare Gravitationseinheiten wurden im Rahmen einer prospektiven Studie untersucht. Ihre Effektivität wird in einer prospektiv randomisierten Studie geprüft.

Summary

Due to the increasing methodical quality of clinical research on normal pressure hydrocephalus we are able to treat NPH patients evidence based. Epidemiological studies found an incidence of patients with normal pressure hydrocephalus in western countries of 1/100 000 inhabitants / year. Non-invasive diagnostics become more and more relevantly but are not able to replace invasive diagnostics yet. The effectiveness of cerebrospinal fluid shunts has been shown in a randomized controlled study (RCT). Another RCT showed that the complication rate of CSF shunts can be significantly lowered by the use of gravitational units. Safety of programmable gravitational units has been proven in a prospective cohort study. Currently, its effectiveness is examined in an RCT.

Schlüsselwörter

Idiopathischer Normaldruckhydrozephalus - evidenzbasierte Therapie - Anti-Siphon-Devices - programmierbare Gravitationseinheiten

Keywords

Idiopathic normal pressure hydrocephalus - evidence based therapy - anti siphon devices - programmable gravitational unit

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