Abstract
【Objective】The frequencies of falls and resultant fractures in idiopathic normal pressure hydrocephalus (iNPH) have not been reported in detail so far. To clarify these rates, we retrospectively analyzed the iNPH cases treated at Tokyo Kyosai Hospital.【Methods】We had experienced 291 definite iNPH cases from April 2009 through April 2014. Two hundred seventy six of those patients underwent lumboperitoneal shunt; the remaining 15 ventriculoperitoneal shunt. Excluding 32 cases in which accurate history-taking was impossible, for example, due to dementia lacking spouse and relatives, 259 cases were analyzed.【Results】Of 259 definite iNPH cases (103 women and 156 men; mean age [±SD], 78.2±6.9 years), falls were experienced in 228 (88.0%) and resultant fractures in 65 (25.1%). The locations of the fractures were as follows: thoracolumbar spine, 25; femoral neck, 17; distal radius, 11; rib, 7; clavicle, 5; craniofacial, 5; patella, 2; and ankle, 2. The average duration between fractures and diagnosis of iNPH was 1 year 3 months (6 months to 5 years): it takes a long time to diagnose iNPH even after fractures.【Conclusion】In iNPH, most of the patients experienced falls and a quarter of them suffered from fractures. Therefore, early diagnosis and treatment is important, and establishment of close cooperation among physicians, visiting nurses, and care managers should be encouraged.
