After surgery in patients of the second group PS had a tendency to insignificant decrease of PS (right – 0.9 ± 0.2, left – 0.9 ± 0.1 rad). Fig. 1 illustrates the results of examination of the female patient with INPH. She suffered of headache, but without dizziness and nausea. Evans’s index was 0.26, the level of mental abilities according to FAB score was high – 15 points. Baseline CSF pressure in lumbar cistern was normal (12 mmHg), Rout corresponded to the upper level of the normal

range (15 mmHg/ml/min). BFV in both MCA were also within the normal range, but PI was high and indicated the presence of ICH. At the same time PS and ARI corresponded to normal values and testified an absence CH5424802 of CA disturbance despite enlarged ventricles according to the brain scan imaging. Taking into account minimal clinical symptoms and positive results of CSF monitoring it has been decided to refuse from surgery and to conduct dynamic observation. Further improvement was noted and the patient was discharged from

the hospital on 10th day. Fig. 2 illustrates the results of examination of the male patient with ABT 888 communicating hydrocephalus and clinical signs of ICH. He suffered of headache, gait disturbance, incontinence. Evans’s index was 0.28, the level of mental disorders according to FAB score – 9 points. Baseline CSF pressure in lumbar cistern was 18 mmHg, Rout 17 mmHg/ml/min. BFV in both MCA were within the normal range, but PI was low and indicated an absence of ICH. However, significant decrease of ARI and PS testified marked CA disturbance. The patient underwent ventriculo-peritoneal shunting which led to a significant regression of neurological symptoms. Evans’s index was decreased to 0.12, and the level of mental abilities according to FAB score increased up to 15 points. Fig. 3 illustrates the results of examination of the

same male patient with communicating Fludarabine price hydrocephalus and clinical signs of ICH on the 10th day after operation. After shunting we observed significant increase of both PS and ARI which testified improvement of CA. There has been a further decline in the PI, but without marked changes of BFV. The patient was discharged in fair condition on 12th day after operation. The problem of surgical treatment of patients with hydrocephalus has not been completely solved yet. Considering the high rate of ineffective surgical interventions in hydrocephalus, reliable diagnostic and prognostic indication criteria for surgical operations are required [10]. Monitoring of CSF dynamics, including IT, together with methods of neuroimaging and evaluation of neurological and psychological status, is still necessary and included in recommendations for management of patients with hydrocephalus. However, the use of ICP monitoring and IT is limited in clinical practice.