No abstract available.
Hydrocephalus, Normal Pressure ; Myotonic Dystrophy

Five patients with favorable outcomes after a shunt operation in normal pressure hydrocephalus were analyzed with the aim of identifying consistent findings in a lumbar puncture (LP) test. The cases commonly showed improvement in at least one cognition and two gait LP parameters. We suggest that when judging the effects of LP on a shunt operation, the gait parameters need to be tailored to the gait status and the analyzed LP parameters should be evaluated at least twice at different times.
Cognition ; Gait ; Humans ; Hydrocephalus, Normal Pressure* ; Prognosis* ; Spinal Puncture*

Early detection of AD in its initial or preclinical stage has become increasingly important. We report a 73-year-old woman who was confirmed to have AD by a cortical biopsy performed concomitantly during a shunt operation for hydrocephalus. The triads of hydrocephalus improved after the operation, as did follow-up neuropsychological and FDG-PET findings. However, 2.5 years after the operation, the patient developed cognitive declines with abnormal behaviors, which was considered to be an evolved form of AD from the preclinical stage.
Aged* ; Alzheimer Disease ; Biopsy* ; Brain* ; Female ; Follow-Up Studies ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure*

A 54-year-old man ingesting silver solution over 4 years presented with cognitive impairment and progressive gait disturbance. He had diffuse gray pigmentation on his face and fingertips, suggesting argyria. Brain magnetic resonance imaging (MRI) revealed hydrocephalus and high concentration of silver ion is in blood. This is the first case occuring hydrocephalus associated with the neurotoxicity of silver.
Argyria* ; Brain ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Magnetic Resonance Imaging ; Middle Aged ; Pigmentation ; Silver

OBJECTIVE: The authors analyze prospectively the result of transcranial doppler(TCD) in normal pressure hydrocephalus and compared its cerebral blood flow parameters to radionuclide cerebrospinal fluid(CSF) flow study, postoperative brain computed tomography(CT) findings and clinical outcome, and studied the relationship betweeen cerebral hemodynamics and clinical performance. METHODS: Twenty five patients with hydrocephalus undertook pre- and post-operative TCD but only preoperative CSF flow study was performed. Mean flow velocity(Vm), pulsatility index(PI) and resistance index(RI) were assessed through TCD and changes in ventricle size and cortical gyral atrophy were checked through brain CT. RESULTS: Postoperative hydrocephalus showed an increase in Vm(ACA P=0.037, MCA P=0.034), decrease in PI(ACA P=0.019, MCA P=0.017) and decrease in RI (ACA P=0.017, MCA P=0.021) compared to preoperative TCD parameters in the postoperative improvement group. In the postoperative improvement group, postoperative TCD parameters correlated with CSF flow study grade (Vm: R2=-0.75, PI: R2=0.86, RI: R2=0.78) and ventriculocranial ratio change correlated with PI change (R2=0.73). The convexity gyral atrophy and initial TCD parameters showed close relationship to outcome. CONCLUSION: PI and RI can be used as an indicator of post operative prognosis, and with the addition of CSF flow study values, can also be used as a tool to predict pre-op and post-op patient status and successful shunt surgery.
Atrophy ; Brain ; Cerebrospinal Fluid* ; Hemodynamics ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Prognosis ; Prospective Studies

The author reviewed a series of 48patients who underwent lumbo-peritoneal shunt operation at Taegu Catholic University Hospital during recent five years. Among them, 10 cases were excluded in this study because of their poor neurologic status which was not adequate to estimate the operative result. In our series, lumbo-peritoneal shunt was done in 34 cases of communicating hydrocephalus due to aneurysmal subarachnoid hemorrhage, head injury, spontaneous intracerebral hemorrhage with/without intraventicular hemorrhage and brain tumor, 2 cases of pseudomeningocele and 2 cases of normal pressure hydrocephalus. The results of this review demonstrate clinical improvement in 28 cases(73.7%), 10 cases(26.7%) of no clinical improvement. There were 9 complications including 8 shunt dysfunction and 1 infection. Among the 8 cases of shunt dysfunction, 5 cases showed postoperative early clinical improvement but revealed shunt dysfunction of delayed onset. In conclusion, lumbo-peritoneal shunt was considered as a good initial CSF diversion procedure in the treatment of communicating hydrocephalus and pseudomeningocele.
Brain Neoplasms ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Daegu ; Hemorrhage ; Hydrocephalus ; Hydrocephalus, Normal Pressure ; Subarachnoid Hemorrhage

Since the discovery of CT scan for brain, the detection of hydrocephalus became easier than before. Of those hydrocephalus, non-parenchymatous in origin, in order words, normal pressure hydrocephalus can be differentiated by RISA cisternography. The etiology, symptomatology and surgical outcome of 16 cases of normal pressure hydrocephalus were presented. Followings are the results. 1) All of the cases revealed ventriculomegaly in brain CT scan and prolonged ventricular retention of dye in RISA cisternogram. 2) Ventriculoperitoneal shunt was done on all of the patients and outcome was excellent:3, good:6, fair:3 and poor:4. 3) It is thought that the prognosis is much related duration of clinical manifestation; the earlier surgery, the better outcome.
Brain ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Prognosis ; Tomography, X-Ray Computed ; Ventriculoperitoneal Shunt

A 68-year-old man presented with progressive impairment of gait, balance, and memory. He exhibited a slow and unstable gait. Formal neuropsychological evaluation showed a deficit in visuospatial function and memory with frontal dysfunctions. He was diagnosed as idiopathic normal pressure hydrocephalus with an Evans' ratio of 0.35. Four-and-a-half years after ventriculoperitoneal shunt placement, he showed a marked improvement in gait, as well as in visuospatial and frontal lobe functions. He benefited from shunt surgery for at least four-and-a-half years.
Aged ; Follow-Up Studies ; Frontal Lobe ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure ; Memory ; Ventriculoperitoneal Shunt

The discovery of C-T scan have facilitated the detection of post-traumatic hydrocephalus cases. Of those, 6 cases of hydrocephalus of non-parenchymatous in origin, in other words, normal pressure hydrocephalus were presented. They were diagnosed by repeated brain C-T and cisternography with Iodine 131-labeled human serum albumin. The symptomatology, diagnosis procedure and surgical results were discussed. Followings are the results. 1) The RIHSA cisternogram taken after 6 hrs, 12 hrs, 24 hrs and 48 hrs from lumbar injection showed abnormal features in all cases. 2) Surgical results were thought that there is much correlation with the age and improvement of mental impairments were seen, more or less, in all cases and improvement of gait disturbance and incontinence were seen in 5 cases and 4 cases respectively. 3) In those who sustained severe head injury with delayed recovery, the authors think, repeated check of brain C-T and cisternography is necessitated to perform the V-P shunt or V-A shunt to relieve the symptomatology of normal pressure hydrocephalus.
Brain ; Cerebrospinal Fluid Pressure ; Craniocerebral Trauma ; Diagnosis ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Iodine ; Serum Albumin ; Ventriculoperitoneal Shunt

Normal pressure hydrocephalus(NPH) is defined as a combination of dementia, gait disturbance and/or urinary incontinence, hydrocephalus on C-T scan, with a normal intracranial pressure. The clinical effect of CSF shunting in patients with this syndrome is sometimes striking but generally only 50-60% of the shunted patients benefit from the treatment. So many pre-operative investigations are performed including clinical examination, computed tomography, R-I cistrnography, T1/2 calculated from ventricular volume pressure curve and lumbar drainage. Among the pre-operative investigations, the effect of preoperative lumbar drainage was the most reliable indicator of NPH. The possible mechanisms of improved case are proposed. The differential diagnosis of primary brain atrophy and NPH can be made by the effect of pre-operative lumbar drainage.
Atrophy ; Brain ; Dementia ; Diagnosis, Differential ; Drainage ; Equidae* ; Gait ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure* ; Intracranial Pressure ; Strikes, Employee ; Urinary Incontinence