A recent case in Hsinchu City prompted doctors to issue a warning that urinary incontinence is not only a symptom of dementia, but can also be a symptom of normal pressure hydrocephalus, and family members should seek professional medical advice to treat elderly relatives.
According to a report by National Taiwan University Hospital Hsinchu Branch physician Lee Chien-hsun (李建勳), the hospital recently treated a 70-year-old woman, surnamed Chiang, (江) who was exhibiting urinary incontinence, delayed reaction in speech and regression of memory.
Chiang’s family members had attributed the symptoms to dementia, but after a computed tomography scan, the hospital determined that Chiang suffered from normal pressure hydrocephalus, not dementia.
Chiang underwent a procedure to introduce a ventriculo- peritoneal shunt, which releases excess cerebrospinal fluid from the brain, resulting in the amelioration of many of her symptoms, Lee said.
The procedure, called a ventriculostomy, is standard practice for treating normal pressure hydrocephalus. A valve is inserted to regulate the amount of cerebrospinal fluid being released, Lee said, adding that a balance must be maintained, otherwise there might be no improvement in the patient’s condition or a cerebral hemorrhage could occur.
Normal pressure hydrocephalus is found more often in elderly people, with patients often exhibiting dementia or Parkinson’s-like symptoms — such as difficulty walking, memory loss and urinary incontinence — due to the abnormal accumulation of cerebrospinal fluid that enlarges the cranial chamber and damages nerves, Lee said.
As these symptoms are also characteristic of other diseases that elderly people are susceptible to — including degenerative disc disease, Parkinson’s, Alzheimer’s and vascular dementia — normal pressure hydrocephalus is often overlooked as the cause, Lee said.
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