Normotense hydrocephalus as a cause of deterioration of dementia in a geriatric patient

Overview

Normotense hydrocephalus (NPH) can be one of the causes of rapid development of cognitive defect or sudden deterioration of geriatric patients’ pre-existing dementia. It is fairly easy to detect this condition through common imaging methods, especially by CT or MRI of the brain. The main issue however is that it is necessary to think of the possibility of such diagnosis in the first place.

In order to identify the correct diagnosis it is invaluable to obtain detailed anamnestic data from the patient’s carers or family. If the anamnesis includes information about rapid deterioration of the pre-existing dementia or fast onset of cognitive deficit, we should always consider NPH.

About half of the patients considerably benefit from inserting a VP shunt. After this therapeutic procedure is carried out, many patients show improvement of cognitive functions, ability to move and incontinence.

Those patients whose condition does not improve notably after the VP shunt is inserted very probably suffer from another type of dementia, most likely Biswanger disease ^[3].

KEYWORDS:
normotense hydrocefalus – dementia – Hakim trias – Step test – lumbal puncture – lumbal infusion test – brain CT – VP shunt – anamnesis