Loading...
Prior studies establishing lumboperitoneal or ventriculoperitoneal shunting as a treatment for idiopathic normal pressure hydrocephalus (NPH) have been faulted for their lack of proper randomization and control groups. The SINPHONI trial results showed a good clinical response to shunting in most patients with NPH. This trial also identified tight high-convexity and medial subarachnoid spaces and enlarged Sylvian fissures with ventriculomegaly — termed disproportionately enlarged subarachnoid-space hydrocephalus (DESH) — as predictive of a good response to shunting and as an imaging feature that could help distinguish idiopathic cases from secondary hydrocephalus resulting from subarachnoid hemorrhage, meningitis, or ventricular outflow obs…