Hydrocephalic dementia in Paget disease of the skull: treatment by ventriculoatrial shunt.

Severe dementia and ataxia in an elderly woman were related to hydrocephalus resulting from Paget disease of the skull, with basilar impression. Ventriculoatrial shunting resulted in dramatic improvement. This procedure, rather than suboccipital decompression, is probably the operation of choice, and should be carried out at an early stage.