VENTRICULO-PERITONEAL SHUNT AS A PRINCIPAL SINGLE TREATMENT OF NORMAL PRESSURE HYDROCEPHALUS.

Ozor II, Nwokocha K.

Abstract


INTRODUCTION:

Normal pressure hydrocephalus is a rare condition and one of the treatable causes of dementia that is frequently missed on presentation with differentials like Alzheimers disease, vascular dementia and occasional bladder outlet obstruction and neurogenic bladder being considered first. There is increased prevalence with age.The aim of this paper is to highlight the outcome following VP shunt as the principal single treatment of normal pressure hydrocephalus.

METHOD:  Recruited retrospectively, 6 patients, treated in the last 5 years in two institutions in Enugu, South-East Nigeria.

RESULTS:  A total of 6 patients, five (5) males and one (1) female, all above 60years (except for one male who was 48years) were managed. They all presented with the Hakims triad of gait abnormality, urinary incontinence and dementia. MRIs were done as the gold standard and showed ventriculo-sulcal disproportion. Venrtriculo-peritoneal shunting was done with resolution of gait abnormalities and urinary incontinence in all the patients. Cognitive function had some marginal improvement generally.

CONCLUSION: In the presence of gait abnormalities with or without urinary incontinence and dementia in an elderly patient, there should be a high index of suspicion as there is little awareness especially in other specialties outside neurosurgery. Symptoms can progressively worsen until they become irreversible worsening quality of life for patients in this geriatric population. Early offer of surgical ventriculoperitoneal shunting improve outcome in all these patients.


Keywords


hydrocephalus, gait abnormalities, ventriculo-sulcal, cognitive, incontinence

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References


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