#POV You’re The Doctor Season 2 Episode 1

Answer C: Surgical Insertion of a Shunt. WELCOME BACK TO #POV You’re the Doctor Season 2!

This is Normal pressure hydrocephalus (NPH)! NPH is an abnormal buildup of cerebrospinal fluid (CSF) in the brain's ventricles (cavities). It occurs if the normal flow of CSF is blocked in some way. Blocked flow = ventricles enlarge with fluid = puts pressure on the brain!

NPH occurs most commonly in elderly, and can be caused by head trauma, a tumor, a brain bleed, infection, or sometimes the cause is unknown. The mnemonic to remember the symptoms of NPH is: WET, WACKY, WOBBLY. Wet = Impaired bladder control. WACKY = Progressive mental impairment and dementia. WOBBLY = Problems with walking.

Because these symptoms are similar to those of other disorders such as Alzheimer's disease and Parkinson's, it often is misdiagnosed and never properly treated! The treatment  involves placing a surgical shunt (called a VP shunt) in the brain to drain excess CSF. This allows the brain ventricles to return to their normal size. NPH is a type of REVERSIBLE dementia :) Meaning they can get better!

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Sources: Brain MRI citation: Asadov D, Normal pressure hydrocephalus. Case study, Radiopaedia.org (Accessed on 25 Jan 2023) https://doi.org/10.53347/rID-8401. NPH Information: National Institute of Neurological Disorders and Stroke