Tuesday, 30 October 2007


I saw a gentleman with, apparently, dementia.

He had prostatism.

He had a stroke so his mobility wasn't great.

It transpires that he's actually got Normal Pressure Hydrocephalus (NPH) and I've referred him on to neurosurgeons to try and cure him.

What was embarassing was the "classic" trio of dementia, gait disturbance and urinary incontinence were manifestly present, but I'd missed the significance of the symptoms since I'd thought they were prostate and stroke disease.

Most folk with dementia don't get a CT or MRI scan since it doesn't change management. I did scan him, for no good reason other than it seemed "a bit odd," I'm so glad the clever radiologist chappies commented on the changes suggesting NPH since I'd not have considered it, otherwise.

Scary when good fortune rather than good clinical acumen gets the patient the right care . . .


Elaine said...

Serendipity once again wins the day!

Milk & Two Sugars said...

When the patient comes pre-packaged, it can be hard to remind ourselves to start from the very beginning. Thank goodness your clinical experience that led you to investigate that little bit further, hey?