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[Communicating hydrocephalus. Clinical aspects, diagnosis, pathogenesis]

K L Täschner

    Fortschritte Der Medizin
    |May 12, 1977
    PubMed
    Summary

    Normal-pressure hydrocephalus (NPH) presents with cognitive decline, gait issues, and incontinence, diagnosed via advanced imaging. Treatment involves shunts, with outcomes varying by NPH etiology.

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    Area of Science:

    • Neurology
    • Neurosurgery

    Context:

    • Normal-pressure hydrocephalus (NPH) is a neurological condition characterized by specific clinical symptoms.
    • It presents without elevated intracranial pressure, distinguishing it from other hydrocephalic conditions.

    Purpose:

    • To describe the clinical manifestations of communicating hydrocephalus, specifically normal-pressure hydrocephalus (NPH).
    • To outline diagnostic methods and differentiate between etiological categories of NPH.
    • To discuss prognostic factors and differential diagnoses for NPH.

    Summary:

    • NPH symptoms include progressive psycho-organic alterations, ataxia, tetraspastic signs, and urinary incontinence.
    • Diagnosis is confirmed using pneumencephalography, isotope-cisternography, and contrast-enhanced brain tomography; skull radiographs, EEG, and psychological tests have limited diagnostic value.
    • The condition results from impaired cerebrospinal fluid (CSF) resorption or circulation, with cases categorized by known (Hydrocephalus communicans obstructivus - HCO) or unknown (Hydrocephalus communicans non obstructivus - HCNO) etiology.

    Impact:

    • Distinguishes NPH from other neurological disorders like presenile dementia and cerebrovascular insufficiency.
    • Highlights the importance of etiological differentiation for predicting prognosis after ventricular shunt procedures.
    • Provides a framework for accurate diagnosis and management of NPH patients.

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