[Click! Health] Memory Loss Means Dementia? Suspect 'Jeongsangap Sudusung' (Normal Pressure Hydrocephalus)

Mr. Kim (45, male) suspected cognitive health issues (dementia) when he noticed that his 79-year-old mother had recently been forgetting her apartment password and her walking had become unnaturally slow. He took her to the hospital, where she was diagnosed with a rare condition called 'normal pressure hydrocephalus' instead of dementia. He felt relieved upon hearing that treatment was possible.

'Normal pressure hydrocephalus' is a condition caused by an imbalance of cerebrospinal fluid (CSF) in the brain, resulting in an excessive amount of fluid accumulating and causing symptoms similar to dementia. It occurs in about 2 out of every 100 elderly people over 70 years old. Because its symptoms resemble those of dementia, it is often mistaken for it.

The main symptoms include an unnatural gait characterized by walking with feet wide apart and small steps, dragging the feet, frequent falls, and difficulty maintaining balance. Additionally, patients may experience urinary incontinence, sometimes wetting their clothes before reaching the bathroom. Unlike dementia, which is difficult to treat, 'normal pressure hydrocephalus' is a treatable condition.

The neurosurgery team at Chung-Ang University Hospital, led by Professors Park Yongsuk and Lee Sinheon, in collaboration with Professor Park Gisu from Kyungpook National University School of Medicine, has been performing both the traditional 'ventriculoperitoneal shunt surgery' and a locally anesthetized 'lumbar-peritoneal shunt surgery' on patients diagnosed with 'normal pressure hydrocephalus' since early August.

The standard treatment for 'normal pressure hydrocephalus' involves creating a hole in the skull under general anesthesia to insert a shunt tube (plastic catheter) that diverts excess cerebrospinal fluid from the brain ventricles to the peritoneal cavity, known as 'ventriculoperitoneal shunt surgery.'

Unlike 'ventriculoperitoneal shunt surgery,' 'lumbar-peritoneal shunt surgery' connects a bypass from the lumbar spine to the peritoneal cavity without drilling a hole in the skull (craniotomy). This procedure can be performed under local anesthesia, making it possible to operate on high-risk patients who cannot undergo general anesthesia.

Professor Park Yong-suk, Department of Neurosurgery, Chung-Ang University Hospital

Professor Park Yongsuk of Chung-Ang University Hospital’s Neurosurgery Department stated, “Since normal pressure hydrocephalus is a treatable condition, it should not be left untreated. Early and careful observation of symptoms and active testing are necessary for proper diagnosis. At Chung-Ang University Hospital, we provide patient-tailored treatment for normal pressure hydrocephalus by combining the advantages of both ventriculoperitoneal and lumbar-peritoneal shunt surgeries.”

Although 'normal pressure hydrocephalus' is treatable, it is often mistaken for dementia such as Alzheimer’s disease or Parkinson’s disease and left untreated. It is essential to conduct tests if individuals over 65 experience slowed walking, memory decline, and urinary difficulties.

Diagnosis involves brain CT or MRI scans to confirm enlarged ventricles containing cerebrospinal fluid. Then, a needle is inserted between the lumbar vertebrae to withdraw about 30?50cc of cerebrospinal fluid from the lower back. Improvement in symptoms such as gait, urinary incontinence, and cognitive decline after this procedure helps confirm the diagnosis.

- Feeling weakness in the legs and easily fatigued when walking.

- Walking speed slows down and stride length shortens.

- Sometimes unable to lift the soles of the feet off the ground.

- Frequently falling forward due to inability to maintain body balance.

- Hand tremors or difficulty performing fine motor tasks, resulting in poor handwriting.

- Experiencing urinary incontinence.

- Significant decline in concentration and memory.

- Showing impaired ability to perform complex tasks.

- Speaking less and appearing indifferent, resembling symptoms of depression.

This content was produced with the assistance of AI translation services.