A partial recovery following delayed surgical treatment of normal pressure hydrocephalus

A 66-year-old woman with a history of total hysterectomy (1953) and healed myocardial infarction (1978) first complained in 1981 of signs and symptoms suggestive of normal pressure hydrocephalus. The condition was followed up and in 1983 was confirmed by Computer Assisted Tomography (CT). She was treated by ventriculo-peritoneal shunt only in 1986. Rehabilitation was started as early as possible postoperatively. Of the major neurological signs, namely gait abnormality, incontinence and dementia, only gait abnormality showed some improvement although gait-related cerebellar dysfunction remained unchanged. Thus progression of the disease was halted by the surgical procedure and subsequent rehabilitative therapy was partially effective despite the prolonged delay in operative treatment of the disease in this patient.