Normal-pressure hydrocephalus

evaluation of five-year experience and literature review

Abstract

Normal-pressure hydrocephalus (NPH) is characterized by the clinical triad of gait apraxia, dementia and urinary incontinence, being one of the reversible causes of dementia. The present study evaluated clinical and laboratory data and the patients’ treatment with this disease assisted from 1992 to 1997 in the University Hospital of Ribeirão Preto. The hypothesis of NPH was made in 56 cases, having been confirmed in 30. Disturbances of the motor’s function were verified in 100% of the cases, cognitive alterations in 83,3% and sphincter disorders in 63,3%. The triad was seen in 53,3% of the cases. CT scan showed hydrocephalus in 96,7% of the patients, and in 40% there was still evidence of ischaemic disorders. Patients were submitted to two kinds of treatment: sucessive spinal fluid drainage or ventricular shunts. In the first case improvement was observed in 53,3%, against 63,1% in shunting cases. In conclusion, NPH is a syndrome that is not uncommon, and should always be reminded as a differential diagnosis of dementia and gait disturbances, being a potentially treatable disease .