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Biomédica
versión impresa ISSN 0120-4157versión On-line ISSN 2590-7379
Resumen
SALDARRIAGA-CANTILLO, Alejandra; YEPES-GAVIRIA, Viviana y RIVAS, Juan Carlos. Normal pressure hydrocephalus: Diagnostic delay. Biomed. [online]. 2020, vol.40, n.4, pp.656-663. Epub 09-Dic-2020. ISSN 0120-4157. https://doi.org/10.7705/biomedica.5382.
Introduction:
Normotensive hydrocephalus is a differential diagnosis in the evaluation of the dementia syndrome. The diagnostic protocols would allow detecting this pathology that has more effective treatment than other dementias.
Objective:
To describe a population with clinical suspicion of normal pressure hydrocephalus evaluated in a Colombian psychiatric hospital and discuss the possible reasons for its diagnostic and therapeutic delay.
Materials and methods:
We conducted a retrospective study of medical records to identify patients with suspected normal pressure hydrocephalus during a 5-year period.
Results:
Thirty-five patients with suspected normal pressure hydrocephalus underwent diagnostic lumbar puncture and five of them were considered candidates for a peritoneal-venous shunt, but none underwent this surgical procedure. After three to six months of the lumbar puncture, the gait pattern improved in 22.8% of the patients, cognition in 22.8%, and sphincter control in 11.4%. Improvement was not sustained in the long term (1 year) in any of them.
Conclusion:
This study suggests the poor implementation of the protocols for evaluating patients with cognitive deficits and delays in the diagnosis of normal pressure hydrocephalus. A small number of patients were identified as candidates for treatment. Normal pressure hydrocephalus is a potentially reversible clinical entity with the placement of a peritoneal ventricular shunt, but delays in diagnosis and treatment have deleterious consequences for patients and their families.
Palabras clave : Hydrocephalus/diagnosis; hydrocephalus, normal pressure; spinal puncture; ageism; dementia; primary health care.