Medical Treatment Form
Hydrocephalus Clinic
Introduction of department
1. Hydrocephalus
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- What is hydrocephalus?
- Cerebrospinal fluid circulates in the brain and spinal cord, and when this fluid is increased we call it as hydrocephalus. When cerebrospinal fluid is increased and the ventricle is widened but, brain pressure is normal, we call it as Normal pressure hydrocephalus. Normal pressure hydrocephalus can occur following meningitis, head trauma, and bleeding, and also can occur without any prior diseases. It is a relatively common disease that occurs in 2 out of 100 elderly people, and can be mistaken for Alzheimer's disease or Parkinson's disease.
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- The dilated ventricle compresses the motor nerve fibers, frontal lobe, and the central part that suppresses urine around the ventricle, showing the following characteristic symptoms.
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· Cognitive disorder
· Gait disorder
· Urination disorder
- The dilated ventricle compresses the motor nerve fibers, frontal lobe, and the central part that suppresses urine around the ventricle, showing the following characteristic symptoms.
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- With the first three characteristic symptoms described, we can consider normal pressure hydrocephalus. Imagingly, the size of the ventricle and the low shade around the ventricle are observed by brain CT, and brain MRI can discriminate the accompanying intracranial lesions and evaluate the degree of brain atrophy. Symptoms of normal pressure hydrocephalus are often similar to Alzheimer's disease and Parkinson's disease, which are the most well-known causes of dementia, so differential diagnosis is required. In addition, special MRI and PET tests can be useful to differentiate the degree of symptoms, and neurocognitive tests or gait tests are performed to accurately quantify the degree of symptoms. When normal pressure hydrocephalus is diagnosed, the effectiveness of surgery can be evaluated through a cerebrospinal drainage test through a lumbar puncture
In general, dementia is a disease that is difficult to improve with various drugs and cognitive treatments, but in the case of normal pressure hydrocephalus, symptoms can be expected to improve through surgery. However, even if it is diagnosed as normal pressure hydrocephalus, not all of them are improved by surgery, so it is necessary to accurately evaluate the effectiveness of surgery and other complications for each patient.
- With the first three characteristic symptoms described, we can consider normal pressure hydrocephalus. Imagingly, the size of the ventricle and the low shade around the ventricle are observed by brain CT, and brain MRI can discriminate the accompanying intracranial lesions and evaluate the degree of brain atrophy. Symptoms of normal pressure hydrocephalus are often similar to Alzheimer's disease and Parkinson's disease, which are the most well-known causes of dementia, so differential diagnosis is required. In addition, special MRI and PET tests can be useful to differentiate the degree of symptoms, and neurocognitive tests or gait tests are performed to accurately quantify the degree of symptoms. When normal pressure hydrocephalus is diagnosed, the effectiveness of surgery can be evaluated through a cerebrospinal drainage test through a lumbar puncture
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- If it is diagnosed as normal pressure hydrocephalus, cerebrospinal fluid is drawn from the waist with an injection needle to check for improvement in gait, memory, and urination symptoms. If symptoms improve by drainage of cerebrospinal fluid, an improved effect can be expected through a "shunt (short) operation" that move excessive cerebrospinal fluid in the cranial cavity to other parts of the body, such as the abdominal cavity in the stomach. Conventionally, ventricular-abdominal shunt surgery that connects the brain to the abdominal cavity in the head is common, however the hydrocephalus clinic at Kyungpook National University Chilgok Hospital has shown good results by performing not only ventricular-abdominal shunt surgery but also lumbar-abdominal shunt surgery that connects the waist to the abdominal cavity without performing cranial perforation. Lumbar-abdominal shunt can bypass cerebrospinal fluid from the waist to the abdominal cavity without passing through the skull and brain tissue, and it is a highly satisfactory operation in elderly patients because it does not require general anesthesia and has excellent results. In particular, this clinic started local anesthesia lumbar-abdominal shunt surgery as the lead in Korea, and is currently performing the largest lumbar-abdominal shunt surgery cases in Korea.
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- In the case of secondary normal pressure hydrocephalus accompanied by other preceding diseases, most cases show improvement through surgery. However, in the case of primary normal pressure hydrocephalus, which occurs idiopathically without a preceding disease, about 70-80% of cases show short-term improvement after surgery. However, efforts are needed to maintain the improvement of symptoms in the long run. Moreover, normal pressure hydrocephalus is a disease that occurs in the elderly, and there are many patients with weak cardiovascular and musculoskeletal functions, so the prognosis can be differs depending on the patient’s condition even after surgery is done is different.
Therefore, not only surgery but also continuous rehabilitation treatment afterwards is a very important part. Through specialized rehabilitation treatment, you can improve your sense of balance, strengthen your lumbar muscles, and increase your function by lengthening your walking distance.
- In the case of secondary normal pressure hydrocephalus accompanied by other preceding diseases, most cases show improvement through surgery. However, in the case of primary normal pressure hydrocephalus, which occurs idiopathically without a preceding disease, about 70-80% of cases show short-term improvement after surgery. However, efforts are needed to maintain the improvement of symptoms in the long run. Moreover, normal pressure hydrocephalus is a disease that occurs in the elderly, and there are many patients with weak cardiovascular and musculoskeletal functions, so the prognosis can be differs depending on the patient’s condition even after surgery is done is different.
DOCTOR LIST
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Park, Enuhee
- Department
- Hydrocephalus Clinic
- Specialty
- No data
- Department
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Park, Kisoo
- Department
- Neurosurgery, Brain Tumor Clinic, Pituitary Gland Clinic, Hydrocephalus Clinic
- Specialty
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- Brain tumor (brain endoscopic surgery), pituitary gland disease, cerebrovascular disease, head trauma, gamma knife radiosurgery
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- Department
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Kang, Kyunghun
- Department
- Neurology, Hydrocephalus Clinic
- Specialty
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- Dementia, normal pressure hydrocephalus, Parkinson's disease, memory impairment, forgetfulness, stroke
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- Department