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[Binswanger's disease with normal pressure hydrocephalus. Case report]
Neurologia Medico-Chirurgica
|December 1, 1991
Summary
This study highlights normal pressure hydrocephalus (NPH) in a patient with Binswanger's disease. Ventriculoperitoneal shunting improved NPH symptoms, suggesting CSF flow is crucial in Binswanger's disease.
Area of Science:
- Neurology
- Neurosurgery
- Geriatrics
Background:
- Binswanger's disease, a form of subcortical arteriosclerotic encephalopathy, is characterized by white matter lesions.
- Normal pressure hydrocephalus (NPH) presents with a classic triad of gait disturbance, urinary incontinence, and dementia.
Observation:
- A 72-year-old male with hypertension presented with progressive gait disturbance, urinary incontinence, and dementia.
- Imaging revealed ventriculomegaly, periventricular lucency, and basal ganglia infarctions.
- Cerebrospinal fluid (CSF) dynamics were abnormal, indicating NPH.
Findings:
- CT cisternography showed impaired CSF flow.
- Intracranial pressure monitoring revealed increased B wave percentage and high outflow resistance.
- The patient's symptoms significantly improved after ventriculoperitoneal shunting.
Implications:
- This case suggests a potential link between disturbed CSF dynamics and the pathophysiology of Binswanger's disease.
- Investigating CSF dynamics is important for managing patients with Binswanger's disease, particularly in early stages.
- Ventriculoperitoneal shunting may be an effective treatment for NPH coexisting with Binswanger's disease.