Year: 2017
Type: article
Study design: Case Report
Abstract: Pearls & Oy-sters: Low-pressure hydrocephalus and inadequate shunting PEARLS • Disabling acute or subacute hydrocephalus can occur at low intraventricular pressures (,5-8 cm H 2 O).• A major risk factor for low pressure hydrocephalus (LPH) is chronically shunted hydrocephalus with a medium pressure valve (valve opening pressure z 7-10 cm H 2 O).• The treatment of LPH typically requires ventricular drainage at negative pressures. OY-STERS• Adults with normal pressure hydrocephalus (NPH) frequently improve following ventriculoperitoneal shunting, but many regress to baseline in less than 3 years.• The regression following initial improvement is largely unexplained.• It is possible that persistent ventriculomegaly, resulting from inadequate drainage, promotes the occurrence of LPH in some patients with NPH.We report a case of LPH and discuss how this phenomenon could play a role in the poor response of NPH to ventriculoperitoneal shunting.CASE REPORT A 30-year-old woman was in good health except for a history of frequent headaches since childhood.These headaches occurred every 1-2 weeks and were often associated with photophobia, phonophobia, and nausea.There was a history of depression but no history of traumatic brain injury, prior CNS infections, or developmental delay.The patient's hydrocephalus was discovered fortuitously with a CT head scan (figure 1A) when she was evaluated in an emergency department for a scalp laceration sustained during a domestic altercation.An MRI revealed partial aqueductal stenosis (figure 1, B and C) and no acute intracranial abnormality.A neurologist and neurosurgeon found no abnormalities on physical examination except for mild optic disk blurring in the right eye.An ophthalmologist
Source: Neurology
Institution: SIU Medicine
Language: English
Subfield: Cellular and Molecular Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W2610059346