Normal pressure hydrocephalus: Difference between revisions
From IDWiki
(Imported from text file) |
m (Text replacement - "Clinical Presentation" to "Clinical Manifestations") |
||
| Line 9: | Line 9: | ||
* Vascular dementia |
* Vascular dementia |
||
| − | == Clinical |
+ | == Clinical Manifestations == |
* "Wobbly, wet, and wacky" |
* "Wobbly, wet, and wacky" |
||
Latest revision as of 22:07, 21 July 2020
Differential Diagnosis
- Dementia with Lewy bodies
- Parkinson disease dementia
- Progressive supranuclear palsy
- Multiple system atrophy
- Corticobasal syndrome
- Alzheimer disease
- Vascular dementia
Clinical Manifestations
- "Wobbly, wet, and wacky"
- Presents with gait instability/apraxia ("magnetic gait") progressing over months to years, followed by dementia
- Cognitive symptoms include psychomotor slowing, decreased attention/concentration, impaired executive function, and apathy
- Urinary incontinence is common, presenting first as urgency with an inability to reach the bathroom in time, then later progressing to incontinence with apathy
- There should be no headaches, nausea/vomiting, visual changes, or papilledema
Investigations
- Should have normal CBC, lytes, creatinine, vit B12, TSH, calcium
- CT head showing hydrocephalus
- Lumbar puncture confirming normal pressure
Management
- High-volume lumbar puncture (30 to 50 mL)
- If there is improvement in symptoms, consider implanting a ventriculoperitoneal shunt
