Optic Nerve Sheath Diameter (ONSD) changes in patients with normal pressure hydocephalus – a useful supplement to the spinal tab test

Normal pressure hydrocephalus (NPH) is defined by the clinical triad of characteristic gait disturbance, incontinence and cognitive decline. The clinical diagnosis is supported by a specific imaging pattern. Therapy of choice is cerebrospinal fluid (CSF) removal, for evaluation of permanent shunting the spinal tab test is one of the established diagnostic tests. In spite of exact patient selection a certain amount of patients do not respond significantly to CSF-removal. A possible explanation might be a reduced compliance of the cerebral ventricles, which is already discussed as part of the pathopyhsiology of NP…