Delayed Normal Pressure Hydrocephalus after Deep Brain Stimulation in Parkinson's Disease
Bibliographic record
Abstract
BACKGROUND: Deep brain stimulation (DBS) of the bilateral subthalamic nuclei (STN) or globus pallidus internus (GPi) for Parkinson's disease (PD) and dystonia is known for its efficacy despite potential complications. Although acute complications such as intracranial hemorrhage and infections are documented, delayed occurrences like normal pressure hydrocephalus (NPH) post-DBS has not been reported so far. CASES: We present a case series of seven PD patients (from 974) who developed NPH, an average of 10.9 + 3.1 years after DBS (6 STN, 1 GPi) with symptoms of cognitive decline and gait disturbances. Imaging confirmed hydrocephalus meeting NPH criteria (Radscale >4), which was further confirmed by the cerebrospinal fluid tap trial. Treatment with ventriculoperitoneal shunt placement showed significant symptom improvement. CONCLUSION: Recognizing NPH in PD patients even after DBS is crucial for early intervention and improved outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".