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Medicine

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Neurology

Question
19 out of 23
 

A pt has gait difficulty, urinary incontinence, ataxia, most likely diagnosis is (AIPG 2010)



A Normal pressure hydrocephalus

B Diabetes

C Alzheimer’s disease

D Paracentral lobule lesion

Ans. A

Normal pressure hydrocephalus
1). It is a triad of abnormal gait (Ataxic gait), dementia and urinary incontinence.

2). Papilledema is not a feature.

3). NPH is caused by obstruction to normal flow of CSF over the cerebral convexity and delayed absorption into the venous system.

4). H/O conditions producing scarring of basilar meninges such as meningitis, SAH and head trauma.

5). Enlarged lateral ventricles ( Ref. Hariydrocephalus) with little or no cortical atrophy. There is communicating hydrocephalus.

6). CSF – Pressure is in high normal range.

TLC, DLC, Protein, Sugar are normal.

Treatment - Ventricular peritoneal shunt

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