RT Book, Section
A1 Usatine, Richard P.
A1 Smith, Mindy A.
A1 Chumley, Heidi S.
A1 Mayeaux, E.J.
SR Print(0)
ID 57685947
T1 Chapter 232. Normal Pressure Hydrocephalus
T2 The Color Atlas of Family Medicine, 2e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176964-8
LK accessmedicine.mhmedical.com/content.aspx?aid=57685947
RD 2024/04/23
AB A  68-year-old  man  presented  with  a  gradual  onset  of  difficulty  with  his  gait,  increased  urinary  incontinence,  and  difficulty  with  his  memory  during  the  past  several  months.  His  gait  was  wide-based  and  slow,  with  decreased  step  height  and  length.  His  Mini  Mental  State  Examination  was  consistent  with  impaired  cognition.  As  part  of  his  workup,  he  had  a  noncontrast  head  CT,  which  demonstrated  dilated  ventricles  (Figure  232-1)  without  extensive  cortical  atrophy.  He  had  normal  cell  counts  and  opening  pressure  on  a  spinal  tap.  He  was  diagnosed  with  normal  pressure  hydrocephalus  (NPH)  and  referred  to  a  neurosurgeon  to  be  evaluated  for  a  ventricular  shunt.  The  patient  had  the  shunt  placed  (Figure  232-2).  His  gait  and  urinary  incontinence  improved.  Unfortunately,  his  cognitive  impairments  did  not  improve  as  is  often  the  case.