<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1816-8949</journal-id>
<journal-title><![CDATA[Anales de la Facultad de Ciencias Médicas (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[An. Fac. Cienc. Méd. (Asunción)]]></abbrev-journal-title>
<issn>1816-8949</issn>
<publisher>
<publisher-name><![CDATA[EFACIM. Editorial de la Facultad de Ciencias Médicas - Universidad Nacional de Asunción]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1816-89492020000100107</article-id>
<article-id pub-id-type="doi">10.18004/anales/2020.053.01.107-111</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Retraso del diagnóstico en un paciente con Hakim Adams]]></article-title>
<article-title xml:lang="en"><![CDATA[Delayed diagnosis in a patient with Hakim Adams]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Frutos]]></surname>
<given-names><![CDATA[Fabrizio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moguilner]]></surname>
<given-names><![CDATA[Gabriela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Benítez]]></surname>
<given-names><![CDATA[Dulce]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas - Departamento de Neurocirugía]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<volume>53</volume>
<numero>1</numero>
<fpage>107</fpage>
<lpage>111</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1816-89492020000100107&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1816-89492020000100107&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1816-89492020000100107&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La hidrocefalia normotensiva es una patología caracterizada por alteración en la marcha, incontencia vesical, déficit cognitivo, hallazgos imagenológicos de ventriculomegalia comunicante y, presión normal de líquido cefalorraquídeo. Por la ambigüedad de sus síntomas y por la falta de criterios imagenológicos muy concluyentes es una patología de difícil diagnóstico inicial; el paciente muchas veces acude a distintos especialistas por síntomas aislados hasta que se relacionan los mismos y, se deriva el caso a Neurología / Neurocirugía. Se presenta el caso de un paciente de 65 años que presentó un cuadro de 2 años de evolución de incontinencia urinaria tratado como alteración de la micción secundaria a una hiperplasia prostática benigna sin mejoría alguna en ese intervalo de tiempo. Luego se agregó al cuadro una alteración en la marcha que fue poco valorada por el paciente y su entorno, sin ser conscientes del déficit cognitivo hasta que se realizó la evaluación neuropsicológica. Si bien el paciente presentaba la triada clásica que caracteriza a la hidrocefalia de presión normal, no fue hasta dos años luego del inicio del cuadro que se llegó al diagnóstico y, fue intervenido quirúrgicamente. Se colocó una válvula de derivación ventrículo peritoneal de presión media, con la cual presentó una evolución favorable y, resolución absoluta de los síntomas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT 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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[hidrocefalia normotensiva]]></kwd>
<kwd lng="es"><![CDATA[triada clásica]]></kwd>
<kwd lng="es"><![CDATA[déficit cognitivo.]]></kwd>
<kwd lng="en"><![CDATA[Normotensive hydrocephalus]]></kwd>
<kwd lng="en"><![CDATA[classic triad]]></kwd>
<kwd lng="en"><![CDATA[cognitive deficit.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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