Normal pressure hydrocephalus: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Gait disturbance is most common and earliest finding | *Gait disturbance is most common and earliest finding | ||
*Memory loss and dementia symptoms may be mild, subtle | *Memory loss and [[dementia]] symptoms may be mild, subtle | ||
*Incontinence is usually later stage, though sensation of urinary urgency is usually present before incontinence | *[[urinary incontinence|Incontinence]] is usually later stage, though sensation of urinary urgency is usually present before incontinence | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* | *[[Alzheimer's]] | ||
*[[Stroke]] | *[[Stroke]] | ||
*Parkinson's | *[[Parkinson's disease]] | ||
*[[Electrolyte abnormality]] | *[[Electrolyte abnormality]] | ||
*Malignancy | *[[brain tumor|Malignancy]] | ||
*Uremic encephalopathy | *[[uremia|Uremic encephalopathy]] | ||
*Hydrocephalus ex vacuo (diffuse cerebral atrophy on CT) | *Hydrocephalus ex vacuo (diffuse cerebral atrophy on CT) | ||
Revision as of 04:19, 3 October 2019
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 and earliest finding
- 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
- Alzheimer's
- 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.