Normal pressure hydrocephalus

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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 Presentation

  • Gait disturbance
  • Memory loss
  • Incontinence

Labs

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

DDx

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

Management

  • Additional work up warranted for surgical candidate[2]
  • Assessment for Surgical CSF shunting

Also See

Sources

  1. ↑ http://emedicine.medscape.com/article/1150924-overview
  2. ↑ http://emedicine.medscape.com/article/1150924-overview
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