Normal pressure hydrocephalus: Difference between revisions
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==Management== | ==Management== | ||
*Diagnostic and therapeutic large volume CSF removal | |||
*Additional work up warranted for surgical candidate<ref name="medscape"></ref> <ref>Shprecher D, Schwalb J, Kurlan R. Normal pressure hydrocephalus: diagnosis and | *Additional work up warranted for surgical candidate<ref name="medscape"></ref> <ref>Shprecher D, Schwalb J, Kurlan R. Normal pressure hydrocephalus: diagnosis and | ||
treatment. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2674287/ Curr Neurol Neurosci Rep. 2008 Sep;8(5):371-6.]</ref> | treatment. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2674287/ Curr Neurol Neurosci Rep. 2008 Sep;8(5):371-6.]</ref> | ||
Revision as of 21:42, 30 September 2018
Background
- Possible reversible cause of dementia
- CSF buildup in the ventricles leading to increased intracranial pressure with edema of the periventricular white matter and corona radiata
- Sacral motor nerve fibers that produce gait instability; incontinence ensues when compressed
Clinical Features
- Gait disturbance is most common
- Memory loss and dementia symptoms may be mild, subtle
- Incontinence is usually later stage, though sensation of urinary urgency is usually present before incontinence
Differential Diagnosis
- Alzheimers
- Stroke
- Parkinson's Disease
- Electrolyte abnormality
- Malignancy
- Uremic encephalopathy
- Hydrocephalus ex vacuo (diffuse cerebral atrophy on CT)
Evaluation
Management
- Diagnostic and therapeutic large volume CSF removal
- Additional work up warranted for surgical candidate[1] [2]
- Assessment for Surgical CSF shunting
Disposition
- Workup typically is extensive and performed as an outpatient.
- Refer to neurosurgery
Also See
References
- ↑ 1.0 1.1 Schneck MJ. Normal pressure hydrocephalus. Medscape. Retrieved 8/4/2016
- ↑ Shprecher D, Schwalb J, Kurlan R. Normal pressure hydrocephalus: diagnosis and treatment. Curr Neurol Neurosci Rep. 2008 Sep;8(5):371-6.