Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Gait Difficulty And Falls


Consult Page

73F with NPH, unable to ambulate.

Initial Imaging

Fig. 58.1, An axial head CT without contrast demonstrates mildly enlarged ventricles with a right frontal approach ventricular catheter terminating in the body of the left lateral ventricle. In comparison with prior imaging, this is stable (not shown).

Fig. 58.2, XR shunt series demonstrates a Certas valve set to 5. Abdominal XR demonstrates no kinks or disconnections of the distal shunt tubing (not shown).

Walking Thoughts

  • ■

    What is the patient’s neurological exam? Why is she unable to ambulate?

  • ■

    Does she have any other medical comorbidities?

  • ■

    Is the patient having any other symptoms?

  • ■

    What is the timeline of her symptoms?

  • ■

    What is her normal pressure hydrocephalus (NPH) history?

  • ■

    Does the patient have a shunt? If so, when was the shunt placed and what type of shunt does the patient have?

  • ■

    Has the shunt ever been revised? If so, when was it last revised, and what was the indication for revision?

  • ■

    Is the patient having a shunt malfunction?

  • ■

    Does the patient need surgery, and if so, what is the timing of surgery?

  • ■

    Is the patient taking any antiplatelet or anticoagulant medications?

You're Reading a Preview

Become a Clinical Tree membership for Full access and enjoy Unlimited articles

Become membership

If you are a member. Log in here

Related Posts