Démence hydrocéphalique et/ou dégénérative

The authors report ten cases of progressive dementia. Nine are associated with gait disturbances and seven with urinary incontinence. Despite the severity of dementia and Ct Scan signs of cortical atrophy, magnitude of neuroradiological ventricular dilatation and ventricular reflux at isotopic cisternography lead to shunt therapy. After ventricular shunting of CSF, a follow-up at short and long terms shows different clinical evolutions: two transitory improvements, three cases without change and five worsening. Retrospective clinical study of these cases in which diagnosis leads to a degenerative process of the Alzheimer type shows atypical premorbid neuropsychological characteristics by a normal-pressure hydrocephalus. In fact, in the ten cases preoperative neuropsychological investigation shows, at various levels, aphasic, alexic and agraphic signs. Their occurrence in the clinical picture represents an essential contribution to differential diagnosis.