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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949

Abstract

FRUTOS, Fabrizio; MOGUILNER, Gabriela; FERREIRA, Verónica  and  BENITEZ, Dulce. Delayed diagnosis in a patient with Hakim Adams. An. Fac. Cienc. Méd. (Asunción) [online]. 2020, vol.53, n.1, pp.107-111. ISSN 1816-8949.  https://doi.org/10.18004/anales/2020.053.01.107-111.

Normotensive hydrocephalus is a pathology characterized by impaired gait, bladder incontinence, cognitive deficit, images findings of communicating ventriculomegaly and normal cerebrospinal fluid pressure.

Due to the ambiguity of its symptoms and the lack of conclusive images criteria, it is difficult initial diagnosis pathology; the patient often goes to different specialists for isolated symptoms until they are related, and the case is referred to Neurology / Neurosurgery.

We present the case of a patient who presented a 2-year history of urinary incontinence treated as an alteration of urination secondary to a benign prostatic hyperplasia without any improvement in that time interval. Then a gait disturbance was added to the picture that was poorly valued by the patient and his environment, without being aware of the cognitive deficit until a neuropsychological evaluation.

Although the patient presented the classic triad that characterizes normal pressure hydrocephalus, it was not until two years after the onset of the condition that the diagnosis was reached and underwent surgery. A peritoneal ventricular shunt of medium pressure was placed, presenting a favorable evaluation and complete resolution of symptoms.

Keywords : Normotensive hydrocephalus; classic triad; cognitive deficit..

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