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Chronic Alcohol Use Associated Encephalopathy With a Nearly Identical Presentation to Normal Pressure Hydrocephalus.
Shreya Patel1, Vasu Malhotra2, Shani Scwartz3
1Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.
Cureus
|June 14, 2023
Summary
A cisternogram study ruled out normal pressure hydrocephalus (NPH) in a patient with gait disturbance and cognitive decline. Findings indicated normal cerebrospinal fluid (CSF) flow, excluding NPH as the cause.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Normal pressure hydrocephalus (NPH) is a neurological condition characterized by gait disturbance, urinary incontinence, and cognitive impairment.
- Accurate diagnosis of NPH is crucial for timely intervention and management.
Observation:
- A 52-year-old male presented with falls, urinary incontinence, confusion, and appetite loss.
- Brain imaging revealed enlarged ventricles and cortical atrophy, prompting a cisternogram study.
Findings:
- The cisternogram demonstrated a type IIIa cerebrospinal fluid (CSF) flow pattern at 24 hours.
- Absence of radiotracer activity in ventricles at 48 and 72 hours, with activity concentrated in cerebral cortices, ruled out NPH.
- This specific CSF circulation pattern excluded normal pressure hydrocephalus.
Implications:
- Cisternography is a valuable tool for differentiating NPH from other conditions with similar symptoms.
- Accurate diagnosis prevents unnecessary interventions for NPH.
- Further investigation into the cause of the patient's symptoms is warranted.
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