Giant cell arteritis and normal pressure hydrocephalus. A case report.

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.