Normal Pressure Hydrocephalus


Case Discussion
A 76-yo man has increasing difficulty walking. He complains that his feet seem stuck together. He has mild memory loss. He has urge urinary incontinence.

You order the following test:

A. TSH
B. CT scan
C. Carotid ultrasound
D. EEG
E. Cystoscopy

 
Characteristics
(Wacky, Wobbly, and Wet)
  • Clinical triad of:
    • Dementia
    • Ataxia
    • Urinary incontinence
  • Frequency of NPH and response to shunt surgery controversial
  • Ataxia most responsive; dementia probably least responsive

 
Dementia Alzheimer's Dementia
Minor Neuro-cognitive Disorder
“Pseudodementia” (Dementia Syndrome of Depression)
Vascular Dementia
Diffuse Lewy Body Dementia
Frontotemporal Dementia
Normal Pressure Hydrocephalus
Creutzfeldt-Jakob Disease