Hydrocephalus in Paget's disease.
Neurological manifestations in Paget's disease are rare. Hydrocephalus is infrequent, its etiology in Paget's disease being multi-factorial. Surgical and anesthetic procedures may be challenging, requiring special precautions. We describe one such case and discuss these peculiarities. An elderly lady, diagnosed to have Paget's disease presented with features of recent onset dementia, gait disturbances with urinary incontinence. Hydrocephalus secondary to posterior fossa crowding was present. A ventriculo-peritoneal shunt was inserted. Endotracheal intubation proved to be difficult. Modification of the surgical technique was required to ensure a safe procedure. She improved immediately following CSF diversion. Timely CSF diversion yields good results. Certain precautions during anesthesia and surgery can ensure a safe and uneventful peri-operative period.
Moiyadi
A V
AV
Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. aliasgarmoiyadi@yahoo.com
Praharaj
S S
SS
Pillai
V S
VS
Chandramouli
B A
BA
D000368:Aged; D000758:Anesthesia / Q000379:methods / Q000592:standards; D003388:Cranial Fossa, Posterior / Q000000981:diagnostic imaging / Q000473:pathology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D020547:Lateral Ventricles / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods / Q000592:standards; D010001:Osteitis Deformans / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000379:methods / Q000592:standards