Suggest Remedy For Walking Difficulty Caused By Hydrocephalus

Posted on Mon, 28 Dec 2015

Question: I have a family member 53 yo male. Diagnosed with hydrocephalus when he was 4 months old and was fitted with a shunt. He has recently had to retire from his supermarket job of 23 years due to becoming so unbalanced. His balance has deteriorated rapidly the past 12 months. Some days his walking gets better and other days (most) he needs someone with him at all times so he does not fall.

I have provided in the link below CT scans from 2009 and the most recent 2015 one.
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I have a theory that he was mistakenly diagnosed with hydrocephalus. Agenesis of corpus callosum explains all the sings and symptoms that lead to his hydrocephalus diagnosis as a baby. His shunt has not been reviewed or really even looked at since it was installed. Is it possible that he now has an acquired type of NPH which has gone untreated?
Im no doctor just trying to wrap my head around it, we are getting no where here.

Answered by Dr. Olsi Taka (6 hours later)

Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern. I also reviewed the scan images.

Looking at those images it is evident that the brain structure is not well formed. The agenesis of the corpus callosum is truly present and there is diffuse atrophy of the surrounding structures.

I do not think there is normal pressure hydrocephalus as NPH shows enlarged ventricles and there is no enlargement of the ventricles in the current scan. As for what was the motive for putting a shunt in the first place in his childhood I am afraid that it is a difficult question to answer. We have no info on what was the decision based, whether there was imaging or a lumbar puncture done at the time. Cerebral malformations are not isolated so I would not find it surprising at all for there to have been hydrocephalus apart from the agenesis of the corpus callosum as well.

From a practical standpoint, regarding whether there is something else to be done, I am afraid there is not. Be it corpus callosum genesis, be it the hydrocephalus cognitive functions will decline in time and dementia will develop, if I was to judge on that imaging only I am a little surprised he has been functional up to now. Dementia drugs like donepezil/rivastigmine/galantamine and memantine are often used but their value is limited. Of course a blood panel to make sure there is not some additional abnormality such as an infection or a metabolic issue contributing to the quick decline is advised, but since he has been in a hospital I suspect they have been already done.

I remain at your disposal for other questions.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar