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Normal Pressure Hydrocephalus

  • Normal Pressure Hydrocephalus  —   CSF is not absorbed- A form of communicating hydrocephalus, where CSF pressure is normal.
  • Ventricles are chronically dilated.
  • Clinical symptoms– Triad

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  • Diagnosis:
  1. Exclude treatable causes of dementia (e.g. Vitamin B12 deficiency, Hypothyroidism)
  2. Screening Test: CT Scan, MRI Scan
  3. Confirmatory Test:
  4. (Gold Standard) Ventricular Shunting- Diagnostic and therapeutic. Improvement of symptoms on removal of CSF- Not generally done as it is very invasive.
  5. Lumbar Tap is a simple procedure that can be carried out in office settings.
  6. Lumbar drainage- Continuous drainage of CSF (@ 5-10ml/hour) for 2-7 days.

Do not follow up with neuro imaging as ventricular size does not decrease. Follow up on clinical improvement is more important.

 

  1. Other tests: Cisternography, CSF infusion tests.

 

  • Treatment: Ventricular shunting
  • Complications of Shunt:

Infections, Seizures, Hemorrhage, Shunt Failure, Peritnonitis in VP shunts, Arrhythmias and systemic emboli due to incorrect catheter placement

  • I-SHAPE (I-Infections, S-Seizure, Shunt Failure, H-Hemorrhage, A-Arrhythmia, P-Peritonitis E-Emboli)

 

Dr.Harpreet Singh MD, FACP is a Chief Executive Officer and Founder of Vital Checklist and iCrush.org. The text, graphics, images, videos and other material contained in the videos and iCrush Website ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Himanshu Deshwal- Assistant Editor
Dr. Himanshu Deshwal is a fresh graduate out of a reputed medical school in India, the Armed Forces Medical College, Pune. Dr. Deshwal is an active researcher constantly on the look out for projects that may help him hone his talents and abilities to the next level. Being an active sportsman he understands the importance of a holistic approach to healthcare and wellbeing. He has been a keen advocate of following an active lifestyle in midst of our busy lives.

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