A pt has gait difficulty, urinary incontinence, ataxia, most likely diagnosis is (AIPG 2010)
|A||Normal pressure hydrocephalus|
|D||Paracentral lobule lesion|
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