Normotensive hydrocephalus

Normotensive hydrocephalus develops especially in the elderly.Hydrocephalus is a release in which the flow of cerebrospinal fluid (CSF) is blocked after leaving the ventricles, being poorly absorbed and venous system, but remains permeable interventricular communication channels. Some patients have a history of disease such as meningitis meningeeana, subarahnoid hemorrhage or craniocerebral trauma. Some studies have indicated that 1-2% of dementia shows normotensive hydrocephalus.
  Characteristic of this disease is the triad: - Gait disorders, with patients feeling "stuck feet" - Mild to moderate dementia - Urinary incontinence
  These signs appear in other diseases, like Alzheimer's or Parkinson's disease, making it difficult differential diagnosis of these entities.
  Neuroimaging studies highlight the expanding lateral ventricles, present in different stages of cortical atrophy, and atrophy of the hippocampus. CSF pressure is the upper limit of normal because of it being called "normotensive hydrocephalus.
  Proteinorahia, cellularity and glicorahia is within normal limits.Sometimes there is an improvement in gait or cognitive function after a lumbar puncture to harvest 30-50ml CSF, but not proved to be a therapeutic means to be generalized to all patients.
  The differential diagnosis is Alzheimer's disease. Differentiation is difficult because the course may be abnormal in both disease and cortical atrophy is sometimes difficult to visualize by CT or MRI is when disease onset.
  Hydrocephalus surgery is indicated, often optandu for the CSF's are. The ventriculo-peritoneal shunt is used, which is done with a unidirectional valve tube of silicone material, which is mounted under the scalp, bypassing the ear and passing along the neck until the peritoneal cavity where the CSF is reabsorbed. The patient will be monitored regularly required to timely detect and treat any infection or obstruction of the drainage tube. If CSF is drained too fast, intracranial pressure falls below normal, the patient complaining of headache, there is the risk of intracranial hemorrhage. There are also reverse, CSF can be drained sufficiently, increasing intracranial pressure hydrocephalus and the symptoms reappear. In case of infection also appears to fever, pain in the scapular girdle muscles, erythema along the drainage tube.
  As an alternative to ventriculo-peritoneal shunt, can be done and are ventriculo-cardiac or ventriculostomia (making a communication with the third ventricle). Through these maneuvers are both going to improve, and memory.Patients will be carefully selected for surgery, there is the risk of subdural hematoma and infection especially in the elderly or dragged.
  Prognosis depends on associated diseases present, the patient's age at diagnosis and treatment response. It is also important that patients benefit from a recovery and reintegration program.