Elderly

Question 1

What is Normal Pressure Hydrocephalus? What is it caused by?

Answer 1

A reversible cause of dementia seen in elderly patients, caused by reduced CSF absorption at the arachnoid villi

Question 2

What is the Triad for Normal Pressure Hydrocephalus?

Answer 2

ADAM’S or HAKIM’S TRIAD

• Urinary incontinence (wet)
• Dementia and bradyphrenia (wacky)
• Gait disturbance (wobbly)

Question 3

What can Normal Pressure Hydrocephalus be misdiagnosed for?

Answer 3

• Parkinson’s Disease (due to gait)

- Alzheimer’s Disease (cognitive dysfunction)

Question 4

What does imaging of the brain show in Normal Pressure Hydrocephalus?

Answer 4

• Hydrocephalus plus an enlarged fourth ventricle

- Absence of sulcal atrophy

Question 5

What is the management of Normal Pressure Hydrocephalus? What are complications of this management?

Answer 5

VP Shunting

Complication: Infections, Seizures, Intracerebral Haemorrhage