Der idiopathische Normaldruckhydrozephalus

Zusammenfassung

Der idiopathische Normaldruckhydrozephalus ist charakterisiert durch eine Symptomentrias aus Gangstörung, demenzieller Entwicklung und Inkontinenz sowie einer pathologischen Erweiterung des Ventrikelsystems. Die Standardtherapie besteht in der Implantation eines ventrikuloperitonealen Shunts. Trotz moderner Untersuchungsmethoden bleibt die Diagnosestellung schwierig und die zugrundeliegende Pathophysiologie in elementaren Anteilen unverstanden.

Kernaussagen

Die Symptomentrias ist nur in ca. der Hälfte der Patienten vorhanden. Als essenzieller Bestandteil für die Diagnosestellung gilt jedoch die Gangstörung.

In einer Vielzahl der Patienten liegt eine Komorbidität mit anderen Erkrankungen vor, wodurch die Diagnosestellung erschwert und/oder verzögert wird.

Die CT-Diagnostik ist für die Diagnosestellung ausreichend. Die MRT-Untersuchung bietet Vorteile für die Differenzialdiagnostik.

Die zugrundeliegende Pathophysiologie bleibt trotz unterschiedlicher Theorien bisher in wesentlichen Teilen unverstanden. Eine bessere Kenntnis dieser Vorgänge könnte zu einer Modifizierung der Therapie führen.

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