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Prognostic Utility of Disproportionately Enlarged Subarachnoid Space Hydrocephalus in Idiopathic Normal Pressure Hydrocephalus Treated with Ventriculoperitoneal Shunt Surgery: A Systematic Review and Meta-analysis

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Abstract
BACKGROUND:

Disproportionately enlarged subarachnoid space hydrocephalus is a specific radiologic marker for idiopathic normal pressure hydrocephalus. However, controversy exists regarding the prognostic utility of disproportionately enlarged subarachnoid space hydrocephalus.

PURPOSE:

Our aim was to evaluate the prevalence of disproportionately enlarged subarachnoid space hydrocephalus in idiopathic normal pressure hydrocephalus and its predictive utility regarding prognosis in patients treated with ventriculoperitoneal shunt surgery.

DATA SOURCES:

We used MEDLINE and EMBASE databases.

STUDY SELECTION:

We searched for studies that reported the prevalence or the diagnostic performance of disproportionately enlarged subarachnoid space hydrocephalus in predicting treatment response.

DATA ANALYSIS:

The pooled prevalence of disproportionately enlarged subarachnoid space hydrocephalus was obtained. Pooled sensitivity, specificity, and area under the curve of disproportionately enlarged subarachnoid space hydrocephalus to predict treatment response were obtained. Subgroup and sensitivity analyses were performed to explain heterogeneity among the studies.

DATA SYNTHESIS:

Ten articles with 812 patients were included. The pooled prevalence of disproportionately enlarged subarachnoid space hydrocephalus in idiopathic normal pressure hydrocephalus was 44% (95% CI, 34%?54%). The pooled prevalence of disproportionately enlarged subarachnoid space hydrocephalus was higher in the studies using the second edition of the Japanese Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus compared with the studies using the international guidelines without statistical significance (52% versus 43%, P?=?.38). The pooled sensitivity and specificity of disproportionately enlarged subarachnoid space hydrocephalus for prediction of treatment response were 59% (95% CI, 38%?77%) and 66% (95% CI, 57%?74%), respectively, with an area under the curve of 0.67 (95% CI, 0.63?0.71).

LIMITATIONS:

The lack of an established method for assessing disproportionately enlarged subarachnoid space hydrocephalus using brain MR imaging served as an important cause of the heterogeneity.

CONCLUSIONS:

Our meta-analysis demonstrated a relatively low prevalence of disproportionately enlarged subarachnoid space hydrocephalus in idiopathic normal pressure hydrocephalus and a poor diagnostic performance for treatment response.
Author(s)
박호영박채리서종현김민재심우현김상준
Issued Date
2021
Type
Article
Keyword
HumansHydrocephalusNormal Pressure* / diagnostic imagingHydrocephalusNormal Pressure* / surgeryMagnetic Resonance ImagingPrognosisSubarachnoid Space / diagnostic imagingVentriculoperitoneal Shunt*
DOI
10.3174/ajnr.A7168
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7387
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2534610931&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Prognostic%20Utility%20of%20Disproportionately%20Enlarged%20Subarachnoid%20Space%20Hydrocephalus%20in%20Idiopathic%20Normal%20Pressure%20Hydrocephalus%20Treated%20with%20Ventriculoperitoneal%20Shunt%20Surgery:%20A%20Systematic%20Review%20and%20Meta-analysis&offset=0&pcAvailability=true
Publisher
AMERICAN JOURNAL OF NEURORADIOLOGY
Location
미국
Language
영어
ISSN
0195-6108
Citation Volume
42
Citation Number
8
Citation Start Page
1429
Citation End Page
1436
Appears in Collections:
Medicine > Medicine
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