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Vinicius Trindade Gomes da Silva, Fernando Campos Pinto, Felippe Saad, Juliana Benevenuto Tornai, Gisele Cortoni Calia, Manoel Jacobsen Teixeira, Wellingson Silva Paiva
(Division of Neurosurgery, Psychiatry Institute University of São Paulo Medical School, São Paulo, SP, Brazil)
Med Sci Case Rep 2017; 4:56-60
Normal-pressure hydrocephalus (NPH) affects around 0.5% of the population over 65 years old. It is a very rare syndrome, secondary to a posterior fossa arachnoid cyst.
CASE REPORT: Here, we present a case study of a 75-year-old woman, who, since April 2013, had difficulty walking, with progressive deterioration, and also showing some episodes of mental confusion. In September 2013, the condition deteriorated with urinary incontinence and complete inability to walk. The neurological exam showed severe gait apraxia without changes related to strength, reflexes, or sensory coordination. Magnetic resonance imaging revealed a cystic lesion in the posterior fossa with dimensions 5.0×2.7×2.8 cm, suggestive of an arachnoid cyst. The patient underwent a suboccipital craniotomy with fenestration of the cyst. After one year, the patient did not present any symptoms related to NPH.
CONCLUSIONS: We highlight the fact that NPH syndrome treatment should be focused on identifying the original cause. We suggest that arachnoid cysts in patients with NPH symptoms should be considered as a potential cause of this syndrome.