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New-onset hydrocephalus in an adult with cerebral palsy: A case report and review of the literature. | LitMetric

New-onset hydrocephalus in an adult with cerebral palsy: A case report and review of the literature.

J Pediatr Rehabil Med

Department of Physical Medicine & Rehabilitation, Children's Hospital Colorado, University of Colorado Anschutz, Aurora, CO, USA.

Published: September 2024

AI Article Synopsis

  • - Hydrocephalus is often found alongside brain injuries like cerebral palsy (CP) and can appear in early childhood; however, adult-onset hydrocephalus can also occur, as shown in a mid-20s patient with CP.
  • - The patient experienced new leg spasms and tried various treatments with no success, leading to MRI imaging which revealed significant ventriculomegaly and elevated pressure through a lumbar puncture.
  • - Following the placement of a ventriculoperitoneal shunt, the patient's symptoms dramatically improved, emphasizing the need for ongoing monitoring and research on the risk of hydrocephalus in adults with CP.

Article Abstract

Hydrocephalus is a common comorbidity associated with brain injuries, including cerebral palsy (CP). In CP, hydrocephalus typically presents in infancy or early childhood. This report describes a patient in their mid 20 s with mixed dyskinetic-spastic CP with adult-onset hydrocephalus of unknown cause initially presenting with new-onset bilateral lower extremity spasms. Multiple interventions were trialed, including ischial bursal steroid injections, botulinum toxin injections, trigger point injections, multiple oral medications, and physical and massage therapies without benefit. Given lack of treatment response, imaging of the neuraxis was obtained. Magnetic resonance imaging (MRI) of the brain demonstrated new diffuse moderate ventriculomegaly compared to prior MRI. Ophthalmologic evaluation demonstrated papilledema, and opening pressure on lumbar puncture was elevated to 44 mmHg H2O. The patient underwent ventriculoperitoneal shunt placement with rapid and near-resolution of their spasms and pain. This patient represents a unique case of new-onset hydrocephalus in an adult with CP. To ensure appropriate and timely diagnosis and treatment, individuals with neurologic conditions such as CP should have ongoing surveillance and comprehensive evaluation for any neurologic or functional changes, including changes in baseline tone. Future research is needed to better understand if adults with CP are at higher risk for the development of hydrocephalus in adulthood.

Download full-text PDF

Source
http://dx.doi.org/10.3233/PRM-240015DOI Listing

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