Normal pressure hydrocephalus is a treatable syndrome seen in elderly patients who show the classical triad of gait disorder, dementia and urinary incontinence. It may be due to idipathic or secondary causes and is a progressive psychomotor disorder. It was first described by Hakim and Adams in 1965, and sometimes referred as Hakim-Adams syndrome. Brain CT or MRI are used to diagnose this syndrome and cerebrospinal fluid (CSF) drainage gives the additional clue about the probable benefit from a shunt operation. Minimum requirments for the shunt replacement or endoscopic third ventriculostomy operations are, the presence of at least two components of the clinical triad, presence of ventriculomegaly, and normal opening pressure of CSF. In the differential diagnosis of this syndrome, other possible causes of degenerative CNS disorders must be ruled out. The patients whose main presenting symptom is gait disturbance and patients with a short duration of symptoms benefit mostly from these treatment modalities.
Manuel pressure hydrocephalus, shunt, endoscopic third ventriculostomy
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