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Vol. 19. Issue 4.
Pages 309-321 (January 2008)
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Vol. 19. Issue 4.
Pages 309-321 (January 2008)
Alteraciones cognitivas en pacientes con hidrocefalia crónica del adulto (“normotensiva”). Propuesta de un protocolo para su evaluación clínica
Cognitive impairment in Normal Pressure Hydrocephalus (NPH). A proposal for clinical evaluation protocol
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B. Benejam, E. Solana
Unidad de Investigación de Neurotraumatología-Neurocirugía, Institut de Recerca Vall d’Hebron. Barcelona
M.A. Poca*,
, C. Junqué**, J. Sahuquillo*
* Servicio de Neurocirugía y Unidad de Investigación de Neurotraumatología-Neurocirugía Hospital Universitario Vall d’Hebrón, Universidad Autónoma de Barcelona. Barcelona
** Departamento de Psiquiatría y Psicobiología Clínica. Universitat de Barcelona. Barcelona
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Resumen

La hidrocefalia crónica del adulto (HCA), o hidrocefalia a presión normal, se caracteriza por una alteración de la marcha, una incontinencia de esfínteres y un deterioro cognitivo progresivo, asociado a una dilatación variable del sistema ventricular. El tratamiento habitual consiste en la colocación de un sistema de derivación de líquido cefalorraquídeo (LCR). Dadas las características de los pacientes y el riesgo implícito de la cirugía, es fundamental realizar un diagnóstico correcto del síndrome para detectar a aquellos pacientes que pueden obtener un mayor beneficio del tratamiento. La valoración neuropsicológica de estos pacientes puede contribuir, de forma importante, al diagnóstico de la HCA, definiendo el perfil de deterioro cognitivo característico en estos enfermos. La valoración neuropsicológica permite, asimismo, determinar la eficacia del tratamiento quirúrgico y ayuda a detectar la coexistencia de otras causas de demencia. El objetivo de este estudio es definir el patrón de afectación cognitiva en pacientes con HCA y presentar el protocolo de valoración clínico, funcional y neuropsicológico que utilizamos en nuestro centro.

Palabras clave:
Hidrocefalia crónica del adulto
Hidrocefalia normotensiva
Deterioro cognitivo
Tests neuropsicológicos
Demencia
Abreviaturas:
EA
FAB
FPH
HCA
HDS
LCR
MDRS
MMSE
MPT
NPH
Summary

Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, urinary incontinence and dementia, and is associated with variable ventricular enlargement. The most accepted treatment of NPH is the placement of a cerebrospinal fluid shunt. Owing to the characteristics of the patients and the invasive nature of the surgical treatment, it is fundamental to detect those patients who could obtain a greater benefit from the treatment. Neuropsychological assessment of these patients could significantly contribute to a better diagnosis of NPH, determining a cognitive deterioration profile for these patients, allowing the assessment of treatment efficacy and helping to detect other additional causes of dementia. The aim of this study is to describe the cognitive deterioration profile of NPH patients and to present the clinical, functional and neuropsychological assessment protocol used in our hospital.

Key words:
Adult Chronic Hydrocephalus
Normal pressure hydrocephalus
Cognitive impairment
Neuropsychological assessment
Dementia

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