Normal pressure hydrocephalus: Difference between revisions

No edit summary
No edit summary
Line 30: Line 30:


==Disposition==
==Disposition==
If onset is chronic, typically refer to neurosurgeon for outpatient follow-up.
*Workup typically is extensive and performed as an outpatient.
*Refer to neurosurgery


==Also See==
==Also See==

Revision as of 21:44, 4 August 2016

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
  • Memory loss
  • Incontinence

Differential Diagnosis

  • Alzheimers
  • Stroke
  • Parkinson's Disease
  • Electrolyte abnormality
  • Malignancy
  • Uremic encephalopathy
  • Hydrocephalus ex vacuo (diffuse cerebral atrophy on CT)

Evaluation

  • CBC
  • Chem 7
  • LP: normal opening pressure
    • Symptom improvement supports diagnosis[1]
  • CT brain

Management

  • Additional work up warranted for surgical candidate[1]
  • Assessment for Surgical CSF shunting

Disposition

  • Workup typically is extensive and performed as an outpatient.
  • Refer to neurosurgery

Also See

References

  1. ↑ 1.0 1.1 http://emedicine.medscape.com/article/1150924-overview
Retrieved from "https://www.wikem.org/w/index.php?title=Normal_pressure_hydrocephalus&oldid=93063"