Open AccessSecondary parkinsonism and normal pressure hydrocephaly because of cranioencephalic trauma: a case report
Author(s) -
Renato Serquiz Elias Pinheiro,
Emanuelly da Costa Nobre Soares,
Maria Eduarda Bezerra Figueiredo,
Stella Mandu Cicco,
Anna Beatriz Graciano Zuza
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.653
Subject(s) - medicine , cerebrospinal fluid , traumatic brain injury , dementia , normal pressure hydrocephalus , etiology , parkinsonism , ventriculomegaly , benserazide , hydrocephalus , anesthesia , surgery , levodopa , disease , parkinson's disease , pregnancy , fetus , psychiatry , biology , genetics
Context: Normal Pressure Hydrocephalus (NPH) occurs due to the quantitative imbalance of cerebrospinal fluid (CSF), changes in absorption or drainage. It shows idiopathic or secondary etiology. Head trauma (TBI) — which causes brain and/or arachnoid granulations fibrosis and inflammation — impairs CSF reabsorption and induces accumulation in the ventricular system. The diagnosis of sNPH was based on a conjunction of symptoms (e.g.: urinary incontinence, dementia, and gait impairment) and imaging studies. Among the treatments with significant clinical improvement, there are ventriculoperitoneal shunt (VP) and tap test. Case report: FAR, a 74-year old man who was diagnosed with parkinsonian syndrome after 6 months of TBI, showed stiffness, bradykinesia and tremor at rest. In addition, he had CT and Skull MRI. Previous studies suggested PNH. Drug therapy with an optimized dose of Levodopa + Benserazide was established. However, it has shown an unsatisfactory response to antiparkinsonian drugs. Hence, he was submitted to the tap test, obtaining functionality and gait reversion as well as cognitive deficits regression. Those results still remained four weeks after the medical procedure. Conclusions: The work aims to emphasize the importance of a positive tap test response as well as early diagnosis and treatment in the outcome of the morbidity.