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Case Report Open Access
Volume 3 | Issue 2 | DOI: https://doi.org/10.46439/neurobiology.3.014

"I’m Feeling Blue": Depression as a presenting symptom of Normal Pressure Hydrocephalus

  • 1College of Science, Engineering, and Technology, Grand Canyon University, Phoenix, Arizona, USA
  • 2Colangelo College of Business, Grand Canyon University, Phoenix, Arizona, USA
  • 3The Dell Medical School, The Department of Neurology, The University of Texas at Austin, Austin, Texas, USA
  • 4Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona, USA 5The University of Texas at Austin, Austin, Texas, USA
  • 5The University of Texas at Austin, Austin, Texas, USA
+ Affiliations - Affiliations

Corresponding Author

Varkey, thmsvrk7@gmail.com

Received Date: April 04, 2021

Accepted Date: April 16, 2021

Abstract

Unusual presentations of disease states that have been well characterized over the years is key to ensuring the safety of patients and decreasing the overall mortality and morbidity. Patients often present with variations on classical conditions and it is key that providers be able to recognize these variations. This case study presents a 70-year-old female with a complex past medical history with variation of the classical Hakim-Adams triad of Normal Pressure Hydrocephalus. In this case, the patient’s symptoms included an increasingly depressed mood with some suicidal ideation, a potentially difficult to parse out gait disturbance, and urinary incontinence that had to be elucidated through conscious efforts. The patient was ultimately referred to neurosurgery for ventricular-peritoneal shunt placement. This case study includes a differential diagnosis with rationale for the different potential diagnoses, an in-depth look at the pathophysiology of Normal Pressure Hydrocephalus, the major treatment strategies, and highlights some clinical pearls for trainees and practicing providers.

Keywords

Normal Pressure Hydrocephalus, Ventricular-peritoneal shunt, Wet, Wacky, Wobbly, Depressed affect

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