hydrocephalus is known excessive accumulation of cerebrospinal fluid (CSF) in the skull, usually associated with dilatation of the cerebral ventricles. The causes may be due to obstruction of the ducts through which the LCR (birth defects, bleeding, tumors, infections ..) or defect in the reabsorption of CSF (communicating hydrocephalus ) which is the most common in the elderly and usually present with normal CSF pressure. When there is a deficit of brain substance (for atrophy, stroke or other causes) increases the amount of CSF, is the hydrocephalus ex-vacuo. The clinic is manifested by the classic triad of cognitive impairment, gait disturbance and incontinence.
The diagnosis is based on the history and neuroimaging studies (Evans index that relates the maximum distance between the frontal horns to the maximum distance between the inner table of skull, in the same court, when greater than 30 is indicative of hydrocephalus .)
The treatment is surgical, bypass valve, obtaining good results when the intervention realiaza promptly (as in other diseases at this age, the diagnosis is often delayed for various reasons). Although cited in different articles, that after treatment you get more improvement in gait disturbance and sphincter in cognition, in my experience, and others, is quite the opposite, better recovery of cognitive disorders and sphincter The march, perhaps by limited number of cases or delay in diagnosis.
The image belongs to a man of 80 with communicating hydrocephalus, by its multi-morbidity was not operated on. Probably there was a delayed diagnosis had previously shown a gait disturbance by bottom monoplegia use of orthotics for polio in childhood and associated urinary incontinence surgery with suprapubic prostatectomy for prostate adenoma. The deterioration of cognitive functions began the study and diagnosis of the disease.
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