Reversible dementia in idiopathic normal pressure hydrocephalus. A case report.

OBJECTIVE

To present a woman with idiopathic normal pressure hydrocephalus (NPH) showing marked improvement in mental function after shunt operation.

DESIGN

Case report.

SETTING

Primary health care.

PATIENT: The clinical symptoms of gait disturbance, occasional urine incontinence and severely impaired mental function typical of NPH were all present. Although dementia predominated in the clinical picture, the diagnosis was confirmed by computer tomography (CT) and cerebrospinal fluid infusion test and cisternography.

MAIN OUTCOME MEASURES: A marked improvement of mental functions was observed after shunt operation.

RESULTS

Mini Mental State Examination score before shunt operation was 9 compared with 20 one year after operation. Also ventricle size was reduced as evaluated by CT scan.

CONCLUSION

This reported case contrasts previous reports concluding that shunt responsive patients have only slight mental disturbances without significant improvement of mental status after shunt operation.