Turkish Neurosurgery 2022 , Vol 32 , Num 6
Normal Pressure Hydrocephalus Overshadowed by Traumatic and Degenerative Spinal Diseases: A New Assessment Proposal
Harun DEMIRCI1,Pelin KUZUCU2,Erdal EROGLU3,Abdullah SERIN4,Ozde SENOL4,Merve Buke SAHIN5,Semih KESKIL6,Pinar OZISIK1
1Ankara Yildirim Beyazit University Faculty of Medicine, Department of Neurosurgery, Ankara, Turkey
2Ankara Bilkent City Hospital, Department of Neurosurgery, Ankara, Turkey
3TOBB University of Economics and Technology, Faculty of Medicine, Department of Neurology, Ankara, Turkey
4TOBB University of Economics and Technology, School of Medicine, Department of Neurosurgery, Ankara, Turkey
5Hacettepe University, School of Medicine, Department of Public Health, Ankara, Turkey
6Yuksek Ihtisas University, School of Medicine, Department of Neurosurgery, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.37051-21.3 AIM: To evaluate normal pressure hydrocephalus (NPH) patients who admitted to clinic with a walking disability, depressed mood, cognitive dysfunction, and compromised quality of life in order to create a system for minimizing misdiagnosis, and inaccurate treatment of NPH at the first instance.

MATERIAL and METHODS: In this study, patients diagnosed with NPH and registered in our clinical database from 2015 to May 2019 were retrospectively screened, and a ?Ste-P? formula was applied to devise a new diagnostic scoring system. Representative cases showed that some of the patients received inaccurate medical and surgical treatments before being diagnosed with NPH.

RESULTS: The study found that some of the 29 patients confused dizziness with truncal ataxia or imbalance due to gait abnormality. As the time between the onset of complaints and diagnosis increased, the diagnostic score approached zero, and diagnosis became difficult.

CONCLUSION: Every unnecessary operation carries serious risks that may threaten the life of the patient and decrease the quality of life. These surgeries and instrumentation used also mean additional financial burden to the patient. Similarly, the long-term use of Parkinson?s and dementia medications has a serious economic burden on health insurance systems and is detrimental to the patient?s health. Considering all these diagnoses and physiological conditions that can easily confuse one disease for another, we recommend a new diagnostic scoring system to reduce the possibility of misdiagnosis and treatment of patients with walking disorders. Keywords : Normal pressure hydrocephalus, Dementia, Parkinson disease, Lumbar spinal stenosis

Corresponding author : Pelin KUZUCU, drpelinkuzucu@gmail.com