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Diagnosing Hydrocephalic Dementia

JAMA. 1966;196(10):42. doi:10.1001/jama.1966.03100230024009.
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Hydrocephalic dementia is too often misdiagnosed as brain atrophy, according to an investigator at Cornell University Medical Center.

Reliance should not be placed upon routine skull roentgenographic examination, electroencephalograms, and lumbar puncture in making a differential diagnosis, since these can be normal in the hydrocephalic patient, Paul R. McHugh, MD, associate professor of neurology and psychiatry, told the annual meeting in Philadelphia of the American Academy of Neurology.

In differentiating between hydrocephalus and brain atrophy, he said, these points should be kept in mind,

  1. Gross dilation of the cerebral ventricles is a late event in atrophy, appearing several months after impairment of mental function, whereas dilated ventricles are found at the onset of symptoms in hydrocephalus;

  2. Gross dilation of the fourth ventricle is a further indication of hydrocephalus since this abnormality is not usually seen in atrophy;

  3. It is often difficult to pass air over the cortex


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