Reversible dementia in idiopathic normal pressure hydrocephalus - A case report

Objective - To present a woman with idiopathic normal pressure hydrocephalu s (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 incon tinence and severely impaired mental function typical of NPH Here all prese nt. Although dementia predominated in the clinical picture, the diagnosis w as confirmed by computer tomography (CT) and cerebrospinal fluid infusion t est and cisternography. Main outcome measures - A marked improvement of mental functions was observ ed 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 sign ificant improvement of mental status after shunt operation.