This disorder occurs due to the accumulation of the cerebrospinal fluid (CSF) in the brain, usually caused by an alteration in the physiological reabsorption processes. In general, it manifests in adults over 60 years of age with progressive gait disturbance, urinary incontinence and impaired cognitive functions. The usual treatment is a ventriculoperitoneal shunt (VPS).
The disorder can be diagnosed with a brain MRI in suspected cases. Prior to the implantation of VPS, some confirmatory tests such as a tap test and a lumbar infusion test are usually necessary. The tap test consists in performing an evacuating lumbar puncture to check if there is a clinical improvement in the symptoms. The infusion test consists in recording the CSF pressure while infusing a saline solution at the lumbar level, to check if the CSF pressure curve is altered.
In cases of diagnosis confirmation VPS alleviates the symptoms.
VPS is a valve that connects the cerebral ventricular system with the peritoneal cavity through a silicone tube implanted in the subcutaneous layer of the skin.
Some of these valves are programmable and the opening pressure can be controlled and adjusted according to the symptoms.
Treatments:
Programmable and non-programmable ventriculoperitoneal shunt
Lumboperitoneal shunt
Invasive monitoring of intracranial pressure
Lumbar infusion test (Katzman test) and tap test
Lumbar infusion test (Katzman test) and tap test:
Lumbar infusion test (Katzman test)