title: Ventriculomegaly and balance disturbances in patients with TIA.
abstract: OBJECTIVE
  Dilated ventricles and gait disturbances are common in the elderly, and these are also features of the treatable syndrome idiopathic normal pressure hydrocephalus (INPH). Many studies report an association between hypertension, vascular disease and INPH. The objective of this study was to study the frequency of ventriculomegaly, with or without hydrocephalic symptoms, in patients who had suffered from a transitory ischaemic attack (TIA).
  
  
  METHODS
  Gait, Romberg sign, tandem standing and one-leg stance were consecutively evaluated in elderly > 24 h after a TIA. Ventricular size, white matter lesions and atrophy were assessed on computed tomography scans. Exclusion criteria were conditions possibly influencing the balance tests.
  
  
  RESULTS
  eventy-six patients with TIA out of 105 were included. Ventriculomegaly [Evans Index (EI) > 0.30] was observed in 19.7% and very large ventricles (EI > 0.33) in 7.9%. Ventriculomegaly was found in 58% of the patients with a previous 'history of balance or gait disturbance', but only in 12% of those without any prior disturbance (chi-square test; P = 0.0009). Three out of 76 patients with TIA (3.9%) fulfilled both radiological and clinical criteria for 'possible INPH'.
  
  
  CONCLUSIONS
  Ventriculomegaly is a common finding in elderly. One out of 20 patients with TIA may suffer from INPH, existing before and independent of the TIA diagnosis. Therefore, patients presenting with ventriculomegaly and gait/balance disturbances not attributable to other causes should be referred to a hydrocephalus centre or a neurologist with special interest in INPH.
authors.affiliation: Department of Clinical Neuroscience, Umeå University, Sweden. hanna.israelsson@neuro.umu.se
authors.forename: H
authors.initials: H
authors.lastname: Israelsson
authors.forename: R
authors.initials: R
authors.lastname: Birgander
authors.forename: K
authors.initials: K
authors.lastname: Ambarki
authors.forename: A
authors.initials: A
authors.lastname: Eklund
authors.forename: J
authors.initials: J
authors.lastname: Malm
mesh_terms: D000368:Aged; D001284:Atrophy; D015897:Comorbidity / Q000639:trends; D005260:Female; D020233:Gait Disorders, Neurologic / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D015837:Vestibular Diseases / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology*