A Brief Review on Normal Pressure Hydrocephalus Diagnosis in Primary Neuropsychiatric Care Settings

Yıl 2024, Cilt: 19 Sayı: 3, 174 - 180, 04.11.2024

Abdullah Yıldırım , Derya Türeli

https://doi.org/10.17517/ksutfd.1517990

Öz

Normal pressure hydrocephalus (NPH) is clinically characterized by the triad of mental deterioration, gait disturbance, and urinary incontinence. Correct diagnosis and referral of patients is important because NPH is a potentially treatable cause of cognitive decline and should be distinguished from more common forms of irreversible dementia. Unfortunately, it remains to be a rather underdiagnosed and controversial neuropsychiatric entity even in countries with modern healthcare systems. The diagnostic process is complicated by diverse clinical presentations, especially when the classical triad is incomplete or atypical such as with psychiatric symptoms. This manuscript aims to briefly review atypical clinical presentations of NPH and basic radiologic findings associated with it, and outline some recommendations to primary care physicians for diagnosis and referral.

Anahtar Kelimeler

Normal pressure hydrocephalus,, dementia, Evans index, callosal angle

Birinci Basamak Nöropsikiyatrik Bakım Hizmetlerinde Normal Basınçlı Hidrosefali Tanısına İlişkin Kısa Bir Derleme

Öz

Normal basınçlı hidrosefali klinik olarak zihinsel bozulma, yürüme bozukluğu ve idrar kaçırma üçlüsü ile karakterizedir. Kognitif gerilemenin potansiyel olarak tedavi edilebilir olması nedeniyle diğer daha yaygın, ancak geri dönüşsüz, demans türlerinden ayırt edilmesi gerekmektedir. Normal basınçlı hidrosefali, öte yandan, modern sağlık sistemlerine sahip ülkelerde bile beklenenden az tanı konulan bir nöropsikiyatrik antite olmaya devam etmektedir. Özellikle klasik semptom üçlüsünün gözlenmediği veya psikiyatrik semptomlar gibi atipik semptomlarla prezente olan hastalarda tanısal süreç daha da karmaşık hale gelmektedir. Bu yazıda normal basınçlı hidrosefalinin atipik klinik belirtileri ve temel radyolojik bulguları kısaca gözden geçirilmekte, ve birinci basamakta tanı ve tedavi zincirinin başlatılması için bazı öneriler özetlenmektedir.

Anahtar Kelimeler

Normal bacınçlı hidrosefali, demans, Evans indeksi, kallozal açı

Kaynakça

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