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Idiopathic normal pressure hydrocephalus associated with empty sella
1Department of Neurology, City Hospital, Faenza, Italy.
Neurosurgical Review
|May 19, 1998
Summary
Normal pressure hydrocephalus (NPH) and empty sella (ES) in a 70-year-old female showed no significant improvement after shunt surgery. The co-occurrence may stem from shared mechanisms like transient intracranial pressure increases.
Area of Science:
- Neurology
- Neuroimaging
- Neurosurgery
Background:
- Normal pressure hydrocephalus (NPH) is a neurological condition characterized by gait disturbance, urinary incontinence, and cognitive decline.
- Empty sella (ES) is a condition where the pituitary gland shrinks or flattens within the sella turcica.
- The co-occurrence of NPH and ES is rare and its underlying mechanisms are not fully understood.
Observation:
- A 70-year-old female presented with symptoms suggestive of NPH, including a senile tremor.
- Neuroimaging revealed characteristic findings of both NPH and ES.
- The patient underwent ventriculoperitoneal shunt surgery for NPH management.
Findings:
- The ventriculoperitoneal shunt provided only mild and transient clinical improvement.
- Shunt malfunction was noted subsequently, complicating the management.
- The association between NPH and ES suggests a potential common pathophysiological link.
Implications:
- Transient increases in intracranial pressure may be a unifying mechanism for both NPH and ES.
- Further research is needed to elucidate the relationship between these two conditions.
- This case highlights the complexity of managing patients with coexisting NPH and ES.