Normal pressure hydrocephalus – a case report
DOI:
https://doi.org/10.67667/NEU.v25i1.162Keywords:
Idiopathic normal pressure hydrocephalus, ventriculomegaly, triad: gait impairments, urinary incontinence, cognitive impairmentAbstract
Idiopathic normal pressure hydrocephalus (iNPH) is a chronic steadily progressing disease, typically characterised by ventriculomegaly and a triad of symptoms: gait disturbance, cognitive impairment and urinary incontinence. The pathophysiology of iNPH is multifactorial and cerebrospinal fluid (CSF) hydrodynamic dysfunction may be combined with subcortical vascular dementia. A 55‐year‐old man presented to the Clinic of nervous diseases Alexandrovska hospital with gradually progressing gait and balance disturbances, cognitive decline and urinary incontinence. Brain magnetic resonance imaging showed ventriculomegaly and extensive MRI white matter hyperintensity changes. He was diagnosed with iNPH.
Following the diagnosis, a CSF drainage test was performed with drainage of 30 ml cerebrospinal fluid. Gait testing pre- and postpuncture indicated a clinical improvement. Patient was referred for lumboperitoneal shunting. The importance of a proper diagnosis is particularly important for iNPH, which can be effectively surgically treated. Management of the modifiable vascular risk factors also has beneficial effects on iNPH.
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