a 65 y.o.female

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a 65 y.o.female

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jean robert
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07/03/07 - 06:31 PM

A 65 y.o. female with poor memory , urinary incontinence and gait abnormalities is found on MRI to have an enlarged ventricular system and minimal cortical atrophy. Urinary incontinence in this patient is most likely caused by which of the following?

a) Spinal cord damage
b) Impaired basal ganglia signaling
c)Stretching of descending cortical fibers
d) Impaired reticular formation functioning
e) Stretching of cerebellar inhibitory fibers

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new_n_lost
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07/03/07 - 07:34 PM

c)Stretching of descending cortical fibers << Corona Radiata Which carry the Corticospinal tracts.

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new_n_lost
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07/03/07 - 07:35 PM

Classical Signs of NPH = Normal Pressure Hydrocephalus.

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SmokyWaters
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07/04/07 - 03:17 AM

but classical signs of NPH arent usually present in elderly of this age...
usually a classical patients is a female with age <40 years takin oral contraceptives developin urinary incontinence is emperically treated for pseudotumor cerebri (NPH)

its likely to be in males with calcification of drainage areas fo CSF to venous sinus...

new_n_lost
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07/04/07 - 01:38 PM

SmokyWaters wrote:
but classical signs of NPH arent usually present in elderly of this age...
usually a classical patients is a female with age <40 years takin oral contraceptives developin urinary incontinence is emperically treated for pseudotumor cerebri (NPH)

its likely to be in males with calcification of drainage areas fo CSF to venous sinus...

Disagree On the Age Factor U have Described. NPH is a Disease of the Elderly Pts.

Pseudotumor Cerebri Or Idiopathic Intracranial Hypertension (IIH) Doesnt show any signs of Gait Abnormality or Urinary or Fecal Incontinence.

NPH or Normal Pressure Hydrocephalus is the Triad of Gait Abnormality, Urinary Incontinence and Slow Progressive Dementia. With Head Injury, Sub Arachnoid Hemorrhage And Meningitis with CNS tumors as the least Likely cuase.

Pseudotumor Cerebri is not a Tumor per se and It does occurs Predominatly in Obese Women of Child bearing age. They No Signs of Focal Neuropathy or Cognitive dysfunction which r associated with Raised ICP. Headaches and Papilledema are the only symptoms present.

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faezah
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07/07/07 - 02:24 AM

agrred with NEW N LOST!!

drduck
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07/07/07 - 08:07 AM

has to be descending fibres....Q......clearly stating woman with NPH,
classical presentation with good old age...
no confusion..

hey guys i m sorry but i got a doubt...NPH causes obstr to csf flow anywhere in the CNS....even in the spinal cord....can get compressed...leading to urinary symptoms....
i know this is stupid but tell me why i m not correct.

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