Thursday, February 5, 2015

Study group discussion: Hydrocephalus ex vacuo, normal pressure hydrocephalus and cortical atrophy

What's cerebral cortical atrophy?

Shrinking of the brain tissues, ie loss of neurones, can be focal (small part) or generalized (affects all of the brain). Number of causes such as Alzheimer's or stroke.

There is a disease called hydrocephalus ex vacuo, in which the baby has a smaller brain. But the CSF production is normal. But mostly the doctors end up diagnosing it as hydrocephalus.

Hydrocephalus ex-vacuo occurs when there is damage to the brain caused by stroke or injury, and there may be an actual shrinkage of brain substance. Although there is more CSF than usual, the CSF pressure itself is normal in hydrocephalus ex-vacuo.

We had a case of this in my college, the girl was a three year old..With the grasp reflex still present and no stable head control.

Is it the same as normal pressure hydrocephalus?
Nope. Cause medication and surgery for normal pressure hydrocephalus won't work on this.

Revision question: Tell me the triad of normal pressure hydrocephalus!

Dementia
Gait disturbance
Urinary incontinence

In case you guys don't know, triad for NPH mnemonic: Wibbly wobbly, wacky and wet. For gait disturbances, dementia and urinary incontinence respectively.

Hydrocephalus ex vacuo and cortical atrophy are different entities?

Can't exactly say. May have a cause effect relation.

One causes the other?

Yep.

Got it.

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