Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 9 Issue 1

Chronic Hydrocephalus in Adults (ACH): Experience of the Neurosurgery Team at the Yalgado Ouédraogo University Hospital (CHU-YO)

Yakouba Haro1*, Abdoulaye Sanou2, Inoussa Zoungrana2, Marie Julie Adeline Kyelem/Kafando3, Sylvain D Zabsonre1 and Abel Kabre1

1Neurosurgery Department, Yalgado Ouedraogo University Hospital (CHU-YO), Joseph Ki Zerbo University of Ouagadougou, Burkina Faso
2Neurosurgery Department, Yalgado Ouedraogo University Hospital (CHU-YO), Burkina Faso
3Neurology Department, Yalgado Ouedraogo University Hospital (CHU-YO), Joseph Ki Zerbo University of Ouagadougou, Burkina Faso

*Corresponding Author: Yakouba Haro, Neurosurgery Department, Yalgado Ouedraogo University Hospital (CHU-YO), Joseph Ki Zerbo University of Ouagadougou, Burkina Faso.

Received: October 14, 2024; Published: December 06, 2024

Abstract

Introduction : Adult Chronic hydrocephalus(ACH) was first described in 1965 as normal pressure hydrocephalus (NPH) by Adams and Hakim [1].

Its initial definition was based on the clinical triad (Adams and Hakim triad) associating cognitive, gait and sphincter disorders in association with dilatation of the ventricles and normal CSF pressure on lumbar puncture (LP).

The aim of this study is to lay the foundations of the epidemiology of ACH in Burkina Faso and to describe the difficulties associated with its management from January 2015 to December 2021.

Patients and Method: This was a cross-sectional, descriptive, retrospective study over a 7-year period, including all adult patients managed for chronic hydrocephalus and with usable clinical records.

Results: Thirty-four cases of chronic adult hydrocephalus were included. The mean age was 51.8 years. The sex ratio was 3.85.

The clinical signs were gait disorders in 32 cases (94.12%), intellectual disorders in 26 cases (76.47%), and sphincter disorders in 25 cases (73.53%).

Brain CT scan showed tetraventricular dilatation in 24 patients (70.6%). Preoperative lumbar puncture was performed in 9 cases (26.47%). Thirty (30) cases (88.24%) underwent a ventriculoperitoneal shunt and only one case (2.94%) underwent a ventriculocisternostomy.

After an mean follow-up of 7 months, the results of the treatment were favorable, with improvement in 32 cases (94.1%).

Conclusion: Chronic hydrocephalus in adults is still an uncommon condition in our context. Treatment significantly improves quality of life. Mass screening could be used to recruit a large number of patients for treatment.

 Keywords: Adams Hakim Triad; Chronic Hydrocephalus; Adults; Shunting

References

  1. Adams RD., et al. “Symptomatic Occult Hydrocephalus with Normal Cerebrospinal-Fluid Pressure: A Treatable Syndrome”. New England Journal of Medicine3 (1965): 117‑126.
  2. “Is Normal Pressure Hydrocephalus a Valid Concept in 2002? A Reappraisal in Five Questions and Proposal for a New Designation of the Syndrome as “Chronic Hydrocephalus””. Journal of Neurology, Neurosurgery and Psychiatry 73.1 (2002): 9‑12.
  3. Chazal J., et al. “Hydrocéphalie chronique de l’adulte (ou hydrocéphalie à pression normale) après 40 ans de publications Chronic hydrocephalus in adult (or normal pressure hydrocephalus) forty years later”. Mise au point, La lettre du Neurologue8 (2006): 270‑275.
  4. Hochstetler Alexandra., et al. “Hydrocephalus: Historical Analysis and Considerations for Treatment”. European Journal of Medical Research168 (2022).
  5. Mary P., et al. “Intérêt prédictif de l’évolution des facteurs posturaux et locomoteurs après ponction lombaire soustractive dans l’hydrocéphalie chronique de l’adulte”. Revue Neurologique4 (2013): 321‑327.
  6. De Beer Marlijn H and Philip Scheltens. “Cognitive Decline in Patients with Chronic Hydrocephalus and Normal Aging: ‘Growing into Deficits’”. Dementia and Geriatric Cognitive Disorders Extra3 (2016): 500‑507.
  7. Oliveira Matheus F., et al. “Psychiatric Symptoms Are Present in Most of the Patients with Idiopathic Normal Pressure Hydrocephalus”. Arquivos de Neuro-Psiquiatria6 (2014): 435‑38.
  8. Oliveira Louise Makarem, et al. “Normal-pressure hydrocephalus: A critical review”. Dementia and Neuropsychologia 2 (2019): 133‑143.
  9. Owens Micaela., et al. “Secondary Normal-Pressure Hydrocephalus in Rheumatoid Meningitis”. Case Reports in Neurology2 (2021): 434‑440.
  10. Gleason L., et al. “The Neurobiology of Normal Pressure Hydrocephalus”. Neurosurgery Clinics of North America4 (1993): 667‑675.
  11. Corkill RG and T A Cadoux-Hudson. “Normal Pressure Hydrocephalus: Developments in Determining Surgical Prognosis”. Current Opinion in Neurology6 (1999): 671‑677.
  12. Roblot P., et al. “Communicating Chronic Hydrocephalus: A Review”. La Revue de Médecine Interne11 (2021): 781‑788.
  13. Fichtner Jens., et al. “Hydrocéphalie à pression normale”. Forum Médical Suisse Swiss Medical Forum2930 (2019): 476‑480.
  14. Mongin M., et al. “Hydrocéphalie à pression normale : mise au point et aspects pratiques”. La Revue de Médecine Interne12 (2015): 825‑833.
  15. Ba Momar Codé., et al. “L’hydrocéphalie chronique de l’adulte : À propos de 15 cas”. African Journal of Neurological Sciences 02 (2007): 05‑11.
  16. Missori Paolo and Antonio Currà. “Progressive Cognitive Impairment Evolving to Dementia Parallels Parieto-Occipital and Temporal Enlargement in Idiopathic Chronic Hydrocephalus: A Retrospective Cohort Study”. Frontiers in Neurology 6 (2015): 15.
  17. Williams Michael A and Norman R. Relkin. “Diagnosis and management of idiopathic normal-pressure hydrocephalus”. Neurology: Clinical Practice5 (2013): 375‑385.
  18. Bey E., et al. “Troubles vésico-sphinctériens dans l’hydrocéphalie à pression normale : revue de la littérature”. Progrès en Urologie17 (2016): 1191‑1199.
  19. Amarenco G., et al. “Recommandations concernant l’incontinence urinaire de la personne âgée : construction et validation de l’algorithme décisionnel GRAPPPA”. Progrès en Urologie 4 (2014): 215‑221.
  20. Campos-Juanatey Félix., et al. “Assessment of the Urodynamic Diagnosis in Patients with Urinary Incontinence Associated with Normal Pressure Hydrocephalus”. Neurourology and Urodynamics 5 (2015): 465‑468.
  21. Baroncini M., et al. “Hydrocéphalie chronique de l’adulte : clinique, imagerie et prise en charge”. Pratique Neurologique - FMC 3 (2016): 176‑183.
  22. Eljebbouri Brahim and Brahim ElMostarchid. “Hydrocéphalie à Pression Normale”. Pan African Medical Journal 18 (2014).
  23. Thakur S K., et al. “Lumbar Puncture Test in Normal Pressure Hydrocephalus: Does the Volume of CSF Removed Affect the Response to Tap?” American Journal of Neuroradiology7 (2017): 1456‑1460.
  24. Lim T S., et al. “Repetitive Lumbar Punctures as Treatment for Normal Pressure Hydrocephalus”. European Neurology5 (2009): 293‑297.
  25. Alperin Noam., et al. “Low-dose acetazolamide reverses periventricular white matter hyperintensities in iNPH”. Neurology 15 (2014): 1347‑1351.
  26. Ziebell Morten., et al. “Valves de Dérivation Régulées Par Le Débit versus Régulées Par La Pression Différentielle Pour Des Patients Adultes Atteints d’hydrocéphalie à Pression Normale”. Cochrane Database of Systematic Reviews 5 (2013): 1-24.
  27. Anzai Adriano., et al. “Use of programmable valve versus fixed pressure valve in the treatment of idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis”. Revista da Associação Médica Brasileira 2 (2023): 207‑212.
  28. Dakurah Thomas K., et al. “Management of Hydrocephalus with Ventriculoperitoneal Shunts: Review of 109 Cases of Children”. World Neurosurgery 96 (2016): 129‑1
  29. Haroon Kaisar., et al. “Immediate Post-Operative Outcome of Ventriculoperitoneal Shunt Surgery in NPH Patients”. Bangladesh Journal of Neurosurgery1 (2016): 8‑11.
  30. Shaw Richard., et al. “Clinical Outcomes in the Surgical Treatment of Idiopathic Normal Pressure Hydrocephalus”. Journal of Clinical Neuroscience 29 (2016): 81‑
  31. Nakajima Madoka., et al. “Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus”. Neurologia medico-chirurgica2 (2021): 63‑97.
  32. Kito Yumiko., et al. “Neuropsychiatric Symptoms in Patients with Idiopathic Normal Pressure Hydrocephalus”. Behavioural Neurology3‑4 (2009): 165‑174.
  33. Daou Badih., et al. “Revisiting secondary normal pressure hydrocephalus: does it exist? A review”. Neurosurgical Focus3 (2016): E6.

Citation

Citation: Yakouba Haro., et al. “Chronic Hydrocephalus in Adults (ACH): Experience of the Neurosurgery Team at the Yalgado Ouédraogo University Hospital (CHU-YO)”.Acta Scientific Medical Sciences 9.1 (2025): 11-17.

Copyright

Copyright: © 2025 Yakouba Haro., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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