[A case of normal pressure hydrocephalus with orthostatic hypotension]

A 67-year-old male case of normal pressure hydrocephalus (NPH) after subarachnoid hemorrhage with orthostatic hypotension is reported. He was admitted with gait disturbance two months after a V-P shunt procedure for NPH. Because of shunt malfunction, a triad of clinical symptoms of NPH (dementia, gait disturbance and urinary incontinence) appeared and orthostatic hypotension developed. These conditions gradually worsened. After a reshunting procedure, the triad of NPH symptoms diminished and orthostatic hypotension disappeared. The same etiology that induced NPH symptoms was suspected in this orthostatic hypotension. Tension against the frontal lobes and on the walls of the third ventricle may affect the higher blood pressure regulatory apparatus of the autonomic nervous system which consisted of frontal lobe cortex, limbic system and hypothalamus.