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Giant cell arteritis and normal pressure hydrocephalus. A case report
Italian Journal of Neurological Sciences
|March 1, 1984
Insights
Giant cell arteritis and normal pressure hydrocephalus can occur together. Treatment involved corticosteroids for arteritis and a shunt for hydrocephalus, suggesting a link via cerebrospinal fluid obstruction.
Area of Science:
- Neurology
- Rheumatology
- Neurosurgery
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting medium to large arteries.
- Normal pressure hydrocephalus (NPH) is a neurological disorder characterized by enlarged ventricles and gait disturbance, often treatable with cerebrospinal fluid diversion.
Observation:
- This report details the first known case linking GCA and NPH.
- The patient presented with symptoms indicative of both conditions.
Findings:
- Giant cell arteritis was successfully treated with corticosteroid therapy.
- Normal pressure hydrocephalus necessitated a ventriculo-peritoneal shunt for cerebrospinal fluid diversion.
- Elevated cerebrospinal fluid protein levels were identified as a likely cause of cerebrospinal fluid pathway obstruction, leading to occult obstructive hydrocephalus.
Implications:
- This case suggests a potential pathogenetic link between GCA and NPH, possibly mediated by inflammatory processes affecting cerebrospinal fluid dynamics.
- Understanding this association may improve diagnostic and therapeutic strategies for patients presenting with overlapping symptoms.
- Further research is warranted to elucidate the precise mechanisms underlying this rare comorbidity.
Abstract:
The first known case of association of giant cell arteritis and normal pressure hydrocephalus is described. The arteritis was cured with corticosteroid therapy while hydrocephalus required ventriculo-peritoneal shunt. The high protein content of cerebrospinal fluid of this patient is probably the pathogenetic mechanism of cerebrospinal fluid block, leading to occult obstructive hydrocephalus.