Case Study

• 66 yr old gentleman
• 2 yrs hx of unsteadiness on feet - shuffle when walking
• noticed weakness in the legs
• loss of balance
  
• increase in freqeuncy of micturition
• reduced in memory
  
• in recent 2-3 months, starts to develop tremors in hands when try to do something
• loss of bladder control
• symptoms get worst
• no significant finding in PMHx, DHx, FHx and SHx

Dx:

• Normal pressure hydrocephalus(NMH) aka adult onset hydrocephalus

Triad of NMH:

• ataxia
• dementia
• incontinence

Investigation:

• MRI

Management:

• ventriculo-peritoneal shunt