Shake your head
I felt as if I heard the sound of the sea
This phrase is often used as a joke
Meaning "head into the water"
But actually
Each of us has water in our heads
But if there is too much water
Then something really goes wrong
Recent
Zhijiang Branch of the First Affiliated Hospital of Zhejiang University School of Medicine
Several patients with unsteady walking, great forgetfulness, and even urinary and urinary incontinence came one after another
They are all targeted by a disease called "atmospheric hydrocephalus"
58-year-old uncle "dementia"?
Uncle Chen (pseudonym), a 58-year-old native of Fuyang, opened a small shop in the village when he was young, and he was diligent and social, and together with his wife, he took care of the small shop business quite prosperously, bringing up a pair of children. However, since October last year, the wife has found that there is something wrong with Uncle Chen, who has always been diligent and cheerful.
"At first I stumbled when I walked, and I fell down without any obstacles, and then I started to throw around, I was very forgetful, I often made mistakes in the goods, and people became a little non-talkative, so I asked him, and he couldn't tell what was going on." Sister-in-law Chen said.
Sister-in-law Chen asked Uncle Chen to go to the local hospital for a check-up, but Uncle Chen always felt that he had no problem, but his memory was poor when he was older, and his legs and feet were inconvenient. In February this year, the family rarely sat together to chat, talking about the situation of Uncle Chen, the careful daughter Baidu took a look, found that the father's symptoms are very similar to "Alzheimer's disease" (Alzheimer's disease), after repeated communication with Uncle Chen, finally came to the local hospital for treatment.
After the initial examination, the local hospital said that Uncle Chen's symptoms were very similar to Alzheimer's, but it was recommended to go to the higher hospital for a detailed examination. So, they drove to the Zhijiang Branch of the First Affiliated Hospital of Zhejiang University School of Medicine.
Is there too much water in your head?
Zheng Jiesheng, deputy director of the Department of Neurosurgery of the First Hospital of Zhejiang University, received Chen Shu, learned more about Chen Shu's medical history, and conducted further examinations on him, according to the results of the examination, it was considered that he was likely to suffer from a disease called "atmospheric hydrocephalus".
"Atmospheric hydrocephalus, also known as normal pressure hydrocephalus, is very similar to the clinical manifestations of Alzheimer's disease (Alzheimer's disease) that people often say, and most patients are over 60 years old, which is more likely to be confused with Alzheimer's disease." The performance of the two is similar even on imaging tests such as cranial CT and magnetic resonance imaging, with changes in ventricular enlargement, but Alzheimer's disease is mainly caused by brain atrophy due to ventricular enlargement, while atmospheric hydrocephalus has changes in ventricular morphology in addition to ventricular enlargement. Deputy Director Zheng Jiesheng said.
What is atmospheric hydrocephalus? And why does it cause the manifestation of Alzheimer's disease?
In layman's terms, we do have "water" in our skulls, which is actually cerebrospinal fluid, which circulates between the brain and spinal cord, mainly playing a protective and nutritious role in the brain and spinal cord. Under normal circumstances, there will be about 100-150 ml of cerebrospinal fluid in the skull, and every day the human body will produce 300-500 ml of cerebrospinal fluid, and it will also absorb so much cerebrospinal fluid to maintain dynamic balance. When this balance is broken due to illness or accident, too much cerebrospinal fluid in the skull (which can be understood as too much water in the brain), the ventricles and pools that store cerebrospinal fluid will become larger, compressing normal brain tissue, resulting in a series of symptoms such as walking instability and "dementia", which are similar to Alzheimer's disease.
"Hydrocephalus is a common disease in neurosurgery, from the perspective of cranial pressure, hydrocephalus can be divided into high cranial pressure and atmospheric hydrocephalus, literally it can be understood, high intracranial pressure hydrocephalus can be quickly diagnosed by intracranial pressure detection, and atmospheric hydrocephalus due to normal intracranial pressure, symptoms are not obvious, it is very easy to misdiagnosis." Zhan Renya, chief physician of the Department of Neurosurgery of the First Hospital of Zhejiang University, said, "Its diagnosis needs to combine the symptoms, signs and imaging performance of the patient, of which the lumbar puncture and release of fluid experiment (releasing a certain amount of cerebrospinal fluid through lumbar puncture) is an important method for diagnosing the disease." ”
Atmospheric hydrocephalus can be divided into idiopathic and secondary, secondary may be caused by intracranial hemorrhage, brain trauma, meningitis, brain tumors, etc., if there is the occurrence of the above diseases, special vigilance against the occurrence of hydrocephalus. The idiopathic hydrocephalus currently has an unknown etiology, mostly seen in the elderly over 60 years old, so some scholars call it "adult chronic hydrocephalus" or "senile hydrocephalus", according to relevant research in Japan, in the elderly population over 61 years old, the incidence of idiopathic atmospheric hydrocephalus can reach 1.1%, accounting for 5% of the causes of dementia.
In order to further confirm the diagnosis, after the neurosurgery expert team conducted a lumbar puncture and release experiment on Uncle Chen, the walking gait improved significantly, which also made the diagnosis of atmospheric hydrocephalus more clear. After the lateral ventricular abdominal shunt surgery, Uncle Chen's forgetfulness and walking instability were significantly improved, and he was successfully discharged home.
This disease is highly misdiagnosed
Beware of the following situations
In addition to Uncle Chen, in the recent period, the Zhijiang Branch of the First Hospital of Zhejiang University has also successively received a number of patients with hydrocephalus under constant pressure, and one patient has been suffering from amnesia, walking instability and other symptoms for nearly a year, but he and his family have not paid attention to it until the occurrence of urinary and urinary incontinence, and he was sent for diagnosis.
After consultation and examination, Uncle Chen did not have intracranial hemorrhage, brain trauma and other related diseases, which belonged to idiopathic atmospheric hydrocephalus, and one patient said that three or four years ago, he once hit his head on the corner of the table, because there was no bleeding at that time, and there were no serious symptoms in the follow-up, so he did not care. Experts say his atmospheric hydrocephalus is likely to be related to that head impact.
Although atmospheric hydrocephalus manifests much like Alzheimer's disease, the good news is that this form of dementia is reversible and can be recovered by early diagnosis and treatment. However, if the disease is allowed to progress and become severe, the patient's brain tissue can no longer fully return to its normal form, and even if it is treated, it will leave different degrees of nerve function and limb movement disorders.
Experts from the First Hospital of Zhejiang University remind that people over the age of 60, if there are symptoms similar to Alzheimer's disease such as unstable walking, poor control of bowel movements, cognitive impairment, etc., in addition to going to a specialist to check for Alzheimer's disease, if the effect is not obvious, it is also necessary to pay attention to whether there may be atmospheric hydrocephalus, otherwise it is a pity to delay treatment.
In addition, if there has been a head collision, cerebral hemorrhage, traumatic brain injury, etc., even if the treatment has been completed or no obvious symptoms have appeared at that time, it is necessary to be vigilant in the follow-up whether atmospheric hydrocephalus will occur.