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Hydrocephalus in Paget's disease.

A V Moiyadi1, S S Praharaj, V S Pillai

  • 1Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. aliasgarmoiyadi@yahoo.com

Acta Neurochirurgica
|November 7, 2006
PubMed
Summary
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Neurological complications of Paget's disease, like hydrocephalus, are rare but manageable. This case highlights the importance of specialized anesthetic and surgical care for a safe patient outcome.

Area of Science:

  • Neurology
  • Neurosurgery
  • Anesthesiology

Background:

  • Paget's disease of bone can present with rare neurological complications.
  • Hydrocephalus is an infrequent manifestation, often multifactorial in etiology within Paget's disease.

Observation:

  • An elderly patient with Paget's disease developed dementia, gait issues, and incontinence due to hydrocephalus from posterior fossa crowding.
  • The patient required a ventriculo-peritoneal shunt for cerebrospinal fluid (CSF) diversion.

Findings:

  • Surgical and anesthetic procedures in these patients present unique challenges, necessitating specific precautions.
  • Difficult endotracheal intubation and modified surgical techniques were required, ensuring a safe procedure.
  • Immediate improvement in symptoms was observed post-CSF diversion.

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Implications:

  • Timely cerebrospinal fluid diversion is crucial for favorable outcomes in hydrocephalus associated with Paget's disease.
  • Adherence to specific anesthetic and surgical precautions ensures a safe peri-operative period for patients with Paget's disease.
  • This case underscores the need for multidisciplinary care in managing complex neurological presentations of Paget's disease.