Reviewer: Ramsis Farid Ghaly, MD, FACS (Ghaly Neurosurgical Associates)
Description: This is an extensive literature review of the research into and clinical management of normal pressure hydrocephalus (NPH). In an unbiased manner, the book addresses almost all aspects of this condition and explains various practices as well.
Purpose: It is intended as a timely, comprehensive literature review of the pathophysiology, diagnosis, and treatment of NPH. This is a useful guide, since many practitioners find NPH challenging and the field lacks standardization.
Audience: The book targets neurosurgeons, neurologists, and any medical practitioners who treat diseases of the elderly. It is written by five experts from Germany.
Features: The book covers the history, epidemiology, clinical presentation, pathophysiology, invasive and noninvasive work-up, shunt technology and settings, surgical techniques, endoscopic third ventriculostomy, scales and scores, complications, prognosis, and predictors of NPH. In each section, the data is displayed under subheadings to cover all aspects of the topic. For instance, the section on epidemiology summarizes nine studies, followed by discussions and summaries. The lengthy section on differential diagnosis includes an abundance of tables and criteria on other neurological diseases in the elderly. The section on the work-up includes both invasive and noninvasive techniques, with a focus on newer tests. The surgical management of NPH includes techniques, shunt selections and settings, follow-up, failures, complication avoidance, and prognosis. The book contains diagrams, tables, imaging, and intraoperative photos. I found the discussion, summary, and conclusion at the end of each chapter very helpful.
Assessment: Surgical intervention for NPH is not without risk, and with the elderly, the differential diagnosis list is extensive. A book such as this is of great value to lay the foundation for the future; there is much work to be done. It summarizes the consensus for some of the delicate management strategies and outlines some of the recent developments, such as MR elastography and newer shunt technologies. It also assists practitioners in critical thinking while dealing with such challenging patients. This condition requires a multidisciplinary approach, partnered with technology, for a more decisive direction. This book does a great job of summarizing the current literature to inspire future inquiry.
