Dement Neurocogn Disord.  2018 Mar;17(1):32-36. 10.12779/dnd.2018.17.1.32.

Hydrocephalus in a Patient with Alzheimer's Disease

• Kang MJ
• Park YH
• Kim S
• Yi S

• KMID: 2442815
• DOI: http://doi.org/10.12779/dnd.2018.17.1.32

Abstract

BACKGROUND
Normal pressure hydrocephalus (NPH) is an etiology of dementia that is reversible following cerebrospinal fluid shunt placement, however, surgical intervention not always clinically effective and the respons to shunt therapy is poorly understood. Furthermore, NPH is a source of comorbidity in diseases with neurodegenerative pathology, such as Alzheimer's disease (AD).
CASE REPORT
A 61-year-old woman presented to the neurology clinic with progressive gait difficulties and cognitive impairment over five years. Nine years after ventriculoperitoneal (VP) shunt treatment, the patient began to experience frequent falls. There was no improvement in clinical symptoms after the alteration of valve pressure on the VP shunt. An 18F-florbetaben amyloid positron emission tomography scan showed increased diffusion uptake over the bilateral cortices, precuneus, and posterior cingulate cortex.
CONCLUSIONS
The patient of NPH was unresponsive to shunt therapy due to the development of AD.

Keyword

Hydrocephalus; Alzheimer Disease; Amyloid

MeSH Terms

Accidental Falls
Alzheimer Disease*
Amyloid
Cerebrospinal Fluid Shunts
Cognition Disorders
Comorbidity
Dementia
Diffusion
Female
Gait
Gyrus Cinguli
Humans
Hydrocephalus*
Hydrocephalus, Normal Pressure
Middle Aged
Neurology
Parietal Lobe
Pathology
Positron-Emission Tomography
Amyloid

Figure

• 

  Fig. 1 Brain magnetic resonance imaging at diagnosis and follow-up. Fluid-attenuated inversion recovery images showed severe ventriculomegaly at diagnosis (A). There is no change in ventriculomegaly 9 years after insertion of the ventriculoperitoneal shunt (B).

• 

  Fig. 2 Axial images from amyloid imaging with 18F-florbetaben. 18F-florbetaben amyloid positron emission tomography scan showing increased diffusion uptake over the bilateral cortices, precuneus, and posterior cingulate cortex.

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