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Sri Sutarni
Universitas Muhammadiyah Surakarta
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Dementia Mimicking Presentation in Normopressure Hydrocephalus: A Case Report Susianti, Noor Alia; Nathania, Caroline Evanthe; Prodjohardjono, Astuti; Gofir, Abdul; Setyaningsih, Indarwati; Setyaningrum, Cempaka Thursina Srie; Sutarni, Sri; Putri, Vega Pratiwi
AKSONA Vol. 6 No. 1 (2026): JANUARY 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v6i1.70306

Abstract

Highlight: Normal pressure hydrocephalus (NPH) is characterized by gait apraxia, urinary incontinence, ventriculomegaly, and cognitive impairment that mimics dementia, potentially leading to misdiagnosis. Comprehensive assessment, including clinical examination, brain imaging, and CSF testing, is critical for distinguishing NPH from dementia. Early and prompt diagnosis and treatment of NPH are crucial for improving long-term outcomes.   ABSTRACT Introduction: Normal Pressure Hydrocephalus (NPH) can occur following Traumatic Brain Injury (TBI). It is characterized by ventricular enlargement and presents with a classic triad: gait apraxia, urinary incontinence, and cognitive impairment. Cognitive impairment in NPH often overlaps with other neurocognitive disorders, such as dementia, which frequently leads to misdiagnosis. Case: A 59-year-old man presented with progressive memory decline, bladder incontinence, and gait apraxia following a head trauma. A CT scan performed after the head trauma revealed an intracerebral hemorrhage in the right thalamus. One year later, the patient complained of gait disturbance, as well as urinary and fecal incontinence. His general examination was normal, but the neurological examination showed the presence of a primitive reflex, specifically, the glabellar sign—and the patient exhibited a gait apraxia, poor spontaneity, and slowed speech. Neurobehavioral assessment showed attention and orientation disturbances, sensory cortical aphasia, and dementia syndrome. A follow-up CT scan revealed cerebral atrophy with ventriculomegaly ex vacuo with cerebrospinal fluid leakage. The patient subsequently underwent ventriculoperitoneal shunt therapy, and the cognitive assessment score showed improvement after the procedure. Conclusion: Diagnosing an NPH remains challenging due to the overlap of its cognitive impairment symptoms with other neurocognitive disorders. Furthermore, the treatment response varies widely, posing a further obstacle for clinicians to effectively manage NPH patients. Although early and prompt diagnosis is crucial for successful therapy, it continues to pose a significant challenge for clinicians.
Co-Authors Abdul Gofir Abidah Rohmatillah Ahmad Syafi'i Ma'arif Amelia Nur Vidyanti Anam Sutopo Anis Mahmudah Anis Mahmudah, Anis Antok Aryuana Aprilianto, Muhamad Farhan Ardelia, Berliani Aulia, Syafira Nur Azmi Bayuangga, Halwan Fuad Cahyaningtyas, Putri Charomah Sri Setianing Rahayu Damastuti, Ayun Siwi Dina Maulita Efi Maysaroh Emese Kovácsné Nagy Erlina, Diah Ayu Fafria Fari Hastuti Ferdianto, Juli Gatiniggsih, Rustiwi Harun Joko Prayitno Hasan, Titis Rohmat Hasnawati, Zakiyah Hastuti , Windi Hayati, Hanifah Fajarisna Hermawati Hermawati, Hermawati Hidayati, Miftachul Hindarto Indarwati Indarwati Irmanopaliza, Ade Ismail Setyopranoto Jasno, Jasno Khairunnisaa', Danik Martha Kurniawan Budi Santoso, Kurniawan Budi Laksmiwati, Pasttita Ayu Lestari, Enur Rara Lina Listiana Maghdhuroh, Umi Mahmudah, Mutiara Hisda Mairina, Upik Masduki Masduki Masduki Maulida, Dini Wardani Mawaddah Ar-Rochmah Muhamad Arief Rahman Muhamad Farhan Aprilianto Muhamad Toyib Muhammad Kholid Muhammad Noor Kholid Muhammad Toyib, Muhammad Nagy, Emese Kovácsné Nathania, Caroline Evanthe Nida Sri Utami Nining Setyaningsih Nuqthy Faiziyah Nur Rohman Nur Rohman Pamungkas, Haris Wahyu Pandhita S, Gea Paryono Pasttita Ayu Laksmiwati Peni Suharti Prabandari, Radha Sita Pratama, Muhammad Alif Prodjohardjono, Astuti Puteri, Mei Yunika Putri, Reni Widya Putri, Vega Pratiwi Qhadhavy Putri, Iqlima Khartini Radha Sita Prabandari Rania, Nadhifa Riayuliatun, Evi Rita P Khotimah, Rita P Rita Pramujiyanti Khotimah Rita Rahmaniati Rusdijanto, Titania Alya Ruspeni Daesusi Salsabila Nur Faizzah Santosa, Yoga Tegar Satiti, Sekar Setyaningrum, Cempaka Thursina Srie Setyaningsih, Indarwati Silalahi, Lothar Matheus Manson Vanende Sri Rejeki Subagya Subagya, Subagya Subagya, Nanang Legawa Suharti, Peni Susianti, Noor Alia Sutama Toyib, Muhamad Trihapsari, Nadia Trisni, Rizka Umi S. Intansari Ida Savitri Laksanawati Wibowo, Eko Ari Widiantoro, Rulli Yolanda Ika Damayati Yulia Maftuhah Hidayati Yusuf Zakaria Zakaria, Yusuf