1/22. syndrome of inappropriate secretion of antidiuretic hormone associated with idiopathic normal pressure hydrocephalus.A 79-year-old woman suffering from urinary incontinence and unsteady gait was diagnosed as having idiopathic normal pressure hydrocephalus (NPH) with hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The concentration of antidiuretic hormone was high while the plasma osmolality was low in the presence of concentrated urine during the episodes of hyponatremia. magnetic resonance imaging (MRI) of the head showed enlargement of the third and lateral ventricles. After ventriculoperitoneal shunt surgery, the symptoms of NPH and hyponatremia improved. It may be possibly explained that mechanical pressure on the hypothalamus from the third ventricle is responsible for hyponatremia.- - - - - - - - - - ranking = 1keywords = syndrome (Clic here for more details about this article) |
2/22. Third ventriculostomy in normal pressure hydrocephalus.Improvement in three out of four cases of normal pressure hydrocephalus after third ventriculostomy is reported. Pre- and postoperative ventricular pressure recording suggested that this improvement may be occurring in the absence of an improvement in ventricular pressures. Third ventriculostomy may relieve periventricular tissue stress and thus improve local blood flow, which is a likely mechanism in the syndrome of normal pressure hydrocephalus.- - - - - - - - - - ranking = 1keywords = syndrome (Clic here for more details about this article) |
3/22. Anatomical and psychological mechanism of reduplicative misidentification syndromes.Reduplicative misidentifications syndromes (RMS) are rare memory disorders characterized by the subjective conviction that a place, person or event is duplicated. Even if RMS often follow a right frontal lesion, several studies have stressed the importance of bilateral hemispheric pathology. Moreover, from a psychological perspective, there is uncertainty if this symptom should be considered just as a kind of confabulation or if it should be associated with personal psychosocial and behavioral aspects. We report a patient who developed normal pressure hydrocephalus and RMS one year after a post-traumatic right frontal lesion. At the first neuropsychological evaluation, we found mild impairment of all functions, associated with the presence of reduplicative paramnesia. After the ventricle-peritoneal shunt intervention, we observed a progressive improvement of all functions but the frontal ones. The memory deficit became less specific and the RMS disappeared. We therefore postulate that a focal right frontal lesion is not sufficient to cause RMS per se. Our clinical report suggests that paramnesic events held on reasonable ground, not being just a kind of confabulation.- - - - - - - - - - ranking = 5keywords = syndrome (Clic here for more details about this article) |
4/22. Cystic cavum veli interpositi associated with normal or low pressure hydrocephalus.A new clinical syndrome, characterized by progressive increase in head size (without intracranial hypertension), variable delay in milestones, moderate ventricular dilation, and the presence of a cavum veli interpositi is herein described. The arteriographic and venographic signs are suggestive, but not diagnostic, of the presence of a cavum veli interpositi. pneumoencephalography, with adequate filling of the subarachnoid spaces and ventricles, is essential to confirming the diagnosis. cerebrospinal fluid shunting appears to result in an improvement, but the results cannot as yet be considered definitive since only 10 of our 29 patients were shunted.- - - - - - - - - - ranking = 1keywords = syndrome (Clic here for more details about this article) |
5/22. Normal-pressure hydrocephalus due to tentorial meningioma.Normal-pressure hydrocephalus and the associated triad of dementia, apraxic gait and urinary incontinence may be casued by various, sometimes unsuspected, lesions, usually those that block the flow of cerebrospinal fluid (CSF) around the tentorium. A 58-year-old woman with insidious onset of behaviour and gait problems had occult, normal-pressure hydrocephalus and a tentorial meningioma, resection of which produced complete recovery. This case demonstrates that a distinction must be made between the syndrome of normal-pressure hydrocephalus resulting from disturbance in CSF dynamics and the pathophysiologic features of the underlying lesion.- - - - - - - - - - ranking = 1keywords = syndrome (Clic here for more details about this article) |
6/22. Normal pressure "herniation".INTRODUCTION: hydrocephalus with normal intracranial pressure has rarely been reported to result in herniation. methods: Case report. RESULTS: A 52-year-old man became acutely comatose with extensor posturing and ventriculomegaly 17 days after experiencing a primary ventricular hemorrhage. An external ventricular drain revealed normal intracranial pressure. After 24 hours without improvement with the drain set at a level of 5 mm H2O, negative-pressure siphoning (50 mL of cerebrospinal fluid [CSF] removed) reduced ventricular size and led to dramatic clinical recovery. CONCLUSION: Normal pressure hydrocephalus can result in delayed brainstem herniation after ventricular hemorrhage. CSF siphoning in these patients can reverse the syndrome.- - - - - - - - - - ranking = 1keywords = syndrome (Clic here for more details about this article) |
7/22. arachnoid cyst mimicking normal pressure hydrocephalus. A case report and review of the literature.A case of a 61-year-old female patient who presents with the clinical triad of normal pressure hydrocephalus (NPH), abnormal gait, urinary incontinence and dementia. On CT scanning, she is found to have a large arachnoid cyst which mimicked the syndrome of NPH. This is also the 60th published case of arachnoid cyst presenting over the age of 60.- - - - - - - - - - ranking = 1keywords = syndrome (Clic here for more details about this article) |
8/22. Relationship of new-onset systemic hypertension and normal pressure hydrocephalus.Communicating normal pressure hydrocephalus (NPH) is an important remote complication of traumatic brain injury (TBI). The diagnosis of this hydrocephalus depends largely on clinical signs and symptoms, including cognitive deterioration, gait changes and incontinence. However, many of these signs are also seen during post-traumatic amnesia, making early recognition of this syndrome difficult. A case study of one man post-TBI, who presented with new-onset hypertension as a sign of NPH, prompted a retrospective chart review of all patients admitted over a 2-year period with a diagnosis of NPH. Ninety per cent of patients had one or more of the classic triad of NPH and 25% of patients had symptoms suggestive of raised intracranial pressure (unexplained nausea, headache and visual disturbance). Mean systolic and diastolic blood pressures among the 20 subjects for six consecutive days pre-operatively compared with those for days 8-14 and 15-21 post-operatively showed no significant differences; a subgroup of five patients (25%), however, demonstrated a significant change in blood pressure temporally related to shunting. We suggest that demonstration of new-onset systemic hypertension may also be a clinical sign suggestive of NPH useful in the evaluation of the TBI patient.- - - - - - - - - - ranking = 1keywords = syndrome (Clic here for more details about this article) |
9/22. Sudden infant apnea and insidious hydrocephalus.hydrocephalus secondary to intracranial-intraventricular hemorrhage is a common complication in the clinical course of the high-risk preterm newborn. hydrocephalus in this population may be insidious without obvious intracranial hypertension. apnea and respiratory arrest continue to cause concern following nursery discharge of the high-risk preterm newborn. We report a child who presented to the neonatology service with episodes compatible with serious sudden cardiorespiratory arrest. Insidious "non-hypertensive" hydrocephalus was documented as being responsible for these episodes, which resolved with treatment of the hydrocephalus. The perinatal neurosurgical consultant should be aware of this syndrome and instruct the parents and the pediatricians of these infants, who at the time of discharge are asymptomatic but have ventricular enlargement on neuro-imaging studies. The information presented here is of current importance, since most neonatologists are unaware of the syndrome of insidious hydrocephalus.- - - - - - - - - - ranking = 2keywords = syndrome (Clic here for more details about this article) |
10/22. Amnestic-confabulatory syndrome in hydrocephalic dementia and Korsakoff's psychosis in alcoholism.The clinical course of six alcoholics with Korsakoff's psyter shunt operation. The initial clinical state as well as the symptom improvement showed important similarities between the Korsakoff group and the hydrocephalic dementia group, who improved after shunt operation. Fantastic confabulation and appraxia were only observed in the hydrocephalic dementia group. Psychometrically, both groups showed a similar degree of improvement of the initially impaired verbal memory while only the hydrocephalic dementia group showed impairment of spatial abilities indicating a constructional apraxia. It is suggested that the similarities of the two conditions are related to dysfunction of diencephalic and temporal-limbic structures. The constructional and general apraxia as well as the fantastic confabulation in hydrocephalic dementia indicate a cortical, especially frontal cortical, dysfunction in this disorder.- - - - - - - - - - ranking = 4keywords = syndrome (Clic here for more details about this article) |
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