P.201 Normal pressure hydrocephalus concomitant with Progressive Supranuclear Palsy: an autopsy-confirmed case and review of the literature
Bibliographic record
Abstract
Background: Recent research has identified the coexistence of normal pressure hydrocephalus (NPH) with neurodegenerative disorders, such as progressive supranuclear palsy (PSP). We present a patient with shunt-responsive NPH that was diagnosed with PSP at autopsy, in the absence of the typical clinical features of PSP antemortem. Methods: Medical records were reviewed, including diagnostic imaging and neuropathology. A literature review was conducted. Results: A 78-year-old female presented with a 4-year history of progressive gait dysfunction and cognitive impairment. MRI imaging was consistent with NPH. The patient’s clinical status improved significantly following high-volume lumbar puncture, with TUG test results decreasing to 25.19 sec from 58.73 sec. A lumboperitoneal shunt was inserted. Subsequent clinical improvement was impermanent, despite the absence of shunt malfunction. Autopsy revealed neuropathological findings consistent with PSP. We have identified 7 similar cases of NPH patients found to have concomitant PSP at autopsy in the literature. Like the case we present, these shunted patients experienced an initial, but unsustained, improvement in clinical status. Conclusions: We recommend the clinical management of NPH patients includesurveillance for neurodegenerative disorders. CSF diversion in NPH patients who develop concomitant PSP benefit from CSF diversion, offering them an interval of significantly improved quality of life.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.006 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
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".