2017, Number 1
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Medisur 2017; 15 (1)
Normal pressure hydrocephalus. Case presentation
Rodríguez RMO, Herrera AD, Sánchez LA, Herrera RM
Language: Spanish
References: 30
Page: 113-119
PDF size: 135.39 Kb.
ABSTRACT
Normal Pressure Hydrocephalus, also known as Adult
Chronic Hydrocephalus is usually produced in elder
people due to an increase of cerebrospinal fluid in
brain cavities, in general without an increase of
intracranial pressure, but which can damage the
brain. For such reasons, the case of a 67 year old
mestizo, married patient is presented. She is an
inveterate smoker who started suffering frequent
falls without apparent cause, motor apraxia,
sphincter disorders and perseverance. After
consulting various specialties during a period of four
years without diagnosis, she came to the Neurology
consultation office reporting a deterioration of
walking disturbances, sphincter disorders and very
frequent falls. A research protocol was started due
to the clinical suspect of normal pressure
hydrocephalus which was confirmed by simple CT
scan. It showed a dilation of the third ventricle
without visualizing the fourth with effacement of
convolutions and furrows. Through a Magnetic
Resonance hydrocephalus was corroborated. She
was admitted was medical and surgical treatment.
An adequate valve was selected considering the
hydrodynamic characteristics of the derivative
system. Normal pressure hydrocephalus was
corrected. This presentation is aimed at updating
clinical diagnostic and therapeutic aspects of this
gnoseological entity.
REFERENCES
Hakim S. Algunas observaciones sobre la presión del LCR. Síndrome hidrocefálico en el adulto con ¨presión normal¨ del LCR [Tesis Doctoral]. Bogotá: Universidad Javeriana. Facultad de Medicina; 1964
Hakim S, Adams RD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci. 1965;2(4):307-27
Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH. Symptomatic occult hydrocephalus with ¨normal¨ cerebrospinal fluid pressure. A treatable syndrome. N Engl J Med. 1965;273:117-26
Black PM. Idiopathic normal-pressure hydrocephalus. Results of shunting in patients. J Neurosurg. 1980;52:371-7
Greenberg JO, Shenkin HA, Adam R. Idiopathic normal pressure hydrocephalus: A report of 73 patients. J Neurol Neurosurg Psychiatry. 1977;40:336-41
Vanneste J, Augustijn P, Dirven C, Tan WF, Goedhart ZD. Shunting normal-pressure hydrocephalus: do the benefits outweigh the risks? A multicenter study and literatura review. Neurology. 1992;42(1):54-9
Sahuquillo J, Rubio E, Codina A, Molins A, Guitart JM, Poca MA, et al. Reappraisal of the intracranial pressure and cerebrospinal fluid dynamics in patients with the socalled ¨normal pressure hydrocephalus¨ syndrome. Acta Neurochir (Wien). 1991;112(21):50-61
Krauss JK, Droste DW, Bohus M, Regel JP, Scheremet R, Riemann D, et al. The relation of intracranial pressure B-waves to different sleep stages in patients with suspected normal pressure hydrocephalus. Acta Neurochir (Wien). 1995;136(3-4):195-203
Sahuquillo J, Rubio E, Poca MA, Molins A, Codina A. Alteraciones de la hidrodinámica del líquido cefalorraquídeo. Hipertensión intracraneal. Hidrocefalia. En: Codina A, editores. Tratado de Neurología. Barcelona: ELA; 1994. p. 561-72
Lobato RD, Lamas E, Cordobés F, Muñoz MJ, Roger R. Chronic adult hydrocephalus due to uncommon causes. Acta Neurochir(Wien). 1980;55(1-2):85-97
Albeck MJ, Skak C, Nielsen PR, Olsen KS, Borgesen SE, Gjerris F. Age dependency of resistance to cerebrospinal fluid outflow. J Neurosurg. 1998;89(2):275-8
Hakim S, Venegas JG, Burton JD. The physics of the cranial cavity, hydrocephalus and normal pressure hydrocephalus: mechanical interpretation and mathematical model. Surg Neurol. 1976;5:187-210
Drapkin AJ, Sahar A. Experimental hydrocephalus: cerebrospinal fluid dynamics and ventricular distensibility during early stages. Childs Brain. 1978;4(5):278-88
Stolze H, Kuhtz-Buschbeck JP, Drucke H, Drucke H, Johnk K, Illert M, Deuschl G. Comparative analysis of the gait disorder of normal pressure hydrocephalus and Parkinson´s disease. J Neurol Neurosurg Psychiatry. 2001;70:289-97
Blomsterwall E, Svantesson U, Carlsson U, Tullberg M, Wikkelsö C. Postural disturbance in patients with normal pressure hydrocephalus. Acta Neurol Scand. 2000;102(5):284-91
Fisher CM. Hydrocephalus as a cause of disturbance of gait in the elderly. Neurology. 1982;32(12):1358-63
Lying-Tunell U, Lindblad BS, Malmlund HO, Persson B. Cerebral blood flow and metabolic rate of oxygen, glucose, lactate, pyruvate, ketone bodies and amino acids in patients with normal pressure hydrocephalus before and after shunting and in normal subjects. Acta Neurol Scand. 1977;64(Supl):338-9
de Pedro-Cuesta J, Virués-Ortega J, Vega S, Seijo Martínez M, Saz P, Rodríguez F, et al. Prevalence of dementia and major dementia subtypes in Spanish populations: a reanalysis of dementia prevalence surveys, 1990-2008. BMC Neurology. 2009;9:55
Hernández Valero E, Rodríguez Roque MO. El diagnóstico etiológico del síndrome demencial. Medisur [revista en Internet]. 2006 [citado 23 Feb 2015];4(1):[aprox. 6p]. Disponible en: http://www.medisur.sld.cu/index.php/medisur/article/view/181
Caltagirone C, Gainotti G, Masullo C, Villa G. Neurophysiological study of normal pressure hydrocephalus. Acta Psychiatr Scand. 1982;65(2):93-100
Stambrook M, Cardoso E, Hawryluk GA, Eirikson P, Piatek D, Sicz G. Neuropsychological changes following the neurosurgical treatment of normal pressure hydrocephalus. Arch Clin Neuropsychol. 1988;3(4):323-30
García Pallero M. Hidrocefalia crónica del adulto [Internet]. Madrid: Hospital La Princesa; 2014 [citado 23 Feb 2015]. Disponible en: http://neurocirugia-princesa.net/sesiones-residentes/hidrocefalia-cronica-del-adulto/
Guzmán López S. Fundamentos para el ejercicio de la Medicina. México, DF: Manual Moderno; 2012
Rabadan A, Martín R, García MV, Freue R. Síndrome de Hakim Adams: evaluación de la calidad de vida luego de la cirugía. Rev Argent Neuroc. 2015;29(2):76-9
Gajardo J, Abusleme MT. Plan nacional de demencias: antecedentes globales y síntesis de la estrategia chilena. Rev Médica Clínica Las Condes. 2016;27(3):286-96
Cordero N, Román Cutillas AM, Jorques Infante AM, Olivares Granados G, Saura Rojas JE, Iañez Velasco B, et al. Hidrocefalia crónica del adulto: diagnóstico, tratamiento y evolución. Estudio prospectivo. Neurocirugía. 2013;24(3):93-101
Organización Mundial de la Salud. CIE-lO. Décima revisión de la Clasificación Internacional de las Enfemedades. Trastornos mentales y del comportamiento. Criterios diagnósticos de investigación. Geneva: OMS; 1994
Eide PK, Sorteberg W. Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients. Neurosurgery. 2010;66(1):80-91
Eide PK, Brean A. Cerebrospinal fluid pulse pressure amplitude during lumbar infusion in idiopathic normal pressure hydrocephalus can predict response to shunting. Cerebrospinal Fluid Res. 2010; 70(5)
Sellal F, Becker H. Potentially reversible dementia. Presse Med. 2007;36(2 Pt 2):289-98