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CHRONIC CONFUSION: NORMAL PRESSURE HYDROCEPHALUS

I mention this quite rare condition because it can present with a chronic confusional state, and if diagnosed early it can be treated by neurosurgery. In this condition the chambers inside the brain enlarge. The consequences are threefold: the person develops difficulty in walking (ataxia), becomes incontinent of faeces (but can also be incontinent of urine as well) and develops confusion (usually described initially as loss of short-term memory, i.e. memory for recent events). These three problems are often present in people with advanced dementia, hence the importance of recognizing the problem early. The diagnosis is made on the history, examination and findings on the CT scan, as well as other complicated tests.
If discovered early the potential for recovery is good. A shunt (a long tube) is passed from the chambers in the brain (ventricles) to the blood stream or a body cavity. In this way the excess CSF (cerebrospinal fluid) is diverted and the chambers revert to their normal size. In the past the diagnosis has been made late and the results of surgery have not been good, with very little recovery in mental function and the complications of the surgery to contend with. Early intervention can produce dramatic improvement and full reversal of all symptoms.
*22/128/5*

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