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Objective: To characterize neurocognitive response to cerebrospinal fluid (CSF) diversion during a multiday external lumbar drainage (ELD) trial in patients with suspected normal pressure hydrocephalus (NPH). Methods: Inpatients (N = 70) undergoing an ELD trial as part of NPH evaluation participated. Cognition and balance were assessed using standardized measures before and after a three-day ELD trial. Cognitive change pre- to post-ELD trial was assessed in relation to change in balance, baseline neuroimaging findings, NPH symptoms, demographics, and other disease-relevant clinical parameters. Results: Multiday ELD resulted in significant cognitive improvement (particularly on measures of memory and language). This improvement was independent of demographics, test-retest interval, number of medical and psychiatric comorbidities, NPH symptom duration, estimated premorbid intelligence, baseline level of cognitive impairment, cerebrovascular disease burden, degree of ventriculomegaly, or other NPH-related morphological brain alterations. Balance scores evidenced a greater magnitude of improvement than cognitive scores and were weakly, but positively correlated with cognitive change scores. Conclusions: Findings suggest that cognitive improvement associated with a multiday ELD trial can be sufficiently captured with bedside neurocognitive testing. These findings support the utility of neuropsychological consultation, along with balance assessment, in informing clinical decision-making regarding responsiveness to temporary CSF diversion for patients undergoing elective NPH evaluation. Implications for the understanding of neuroanatomical and cognitive underpinnings of NPH are discussed. [ABSTRACT FROM AUTHOR]

Mental health and traumatic stress symptoms are prevalent in juvenile offenders, yet research on diversion programs rarely examine these important outcomes. Program duration and the role of protective factors are also understudied in this literature. This study examined the impact of program duration and youth protective factors on mental health and traumatic stress symptoms of 713 youth participating in an Illinois diversion program. Overall, the more time youth spent in the diversion program, the more improvement they demonstrated in mental health and trauma symptoms. Both program duration and number of youth strengths at program entry were significantly associated with improvement in mental health and traumatic stress symptoms. Findings highlight the importance of program duration and suggest that youth protective factors should be identified early on and targeted to maximize the impact of juvenile justice diversion programs on mental health and trauma symptoms. [ABSTRACT FROM AUTHOR]