[Normal pressure hydrocephalus in an elderly patient].

Introduction: Idiopathic normal pressure hydrocephalus is a disease that most frequently concerns subjects of an advanced age. It is not easy to establish a definitive diagnosis, and the practitioner frequently encounters decision-making problems regarding the following question: should a shunt be performed, or not? Opinions remain contradictory, even though the available scientific data is increasingly precise. The aim of this review is to analyze the physiopathogenic, clinical, paraclinical and therapeutic data associated with this type of hydrocephalus.

Current Knowledge And Key Points: If the clinical triad is determinant, no other investigation is in fact necessary to confirm the diagnosis, although it should always be questioned in the case of ventricular enlargement determined by tomodensitometry. The decision to perform the only efficient procedure, i.e., a ventricular shunt operation, depends upon a number of established arguments in favor of that procedure. Clinical improvement, which is often spectacular, can then confirm the diagnosis.

Future Prospects And Projects: The efficacy of surgical treatment has been confirmed by clinical studies, and there is a reduced tendency as regards post-operative complications. However, each case should be considered individually and with the cooperation of and coordination between the family, the physician and the neurosurgeon.