pituitrin and Hydrocephalus--Normal-Pressure

A 79-year-old woman suffering from urinary incontinence and unsteady gait was diagnosed as having idiopathic normal pressure hydrocephalus (NPH) with hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The concentration of antidiuretic hormone was high while the plasma osmolality was low in the presence of concentrated urine during the episodes of hyponatremia. Magnetic resonance imaging (MRI) of the head showed enlargement of the third and lateral ventricles. After ventriculoperitoneal shunt surgery, the symptoms of NPH and hyponatremia improved. It may be possibly explained that mechanical pressure on the hypothalamus from the third ventricle is responsible for hyponatremia.

Topics: Aged; Cerebral Ventricles; Female; Follow-Up Studies; Humans; Hydrocephalus, Normal Pressure; Hyponatremia; Inappropriate ADH Syndrome; Magnetic Resonance Imaging; Myelography; Radionuclide Imaging; Sodium; Vasopressins; Ventriculoperitoneal Shunt

In 16 patients with primary degenerative dementia mean CSF vasopressin concentration was lower (0.9 +/- 0.1 pg/ml (mean +/- SEM)) than in 28 control patients (1.3 +/- 0.1 (mean +/- SEM)) (p less than 0.01). In 18 patients with normal pressure hydrocephalus and potentially reversible dementia mean CSF vasopressin concentration (1.2 pg/ml +/- 0.1 (mean +/- SEM)) was not different from that found in controls. Several of the demented patients had inappropriate plasma vasopressin concentrations suggesting a defect in osmoregulation. These findings encourage further clinical trials of vasopressin in patients with primary degenerative dementia, but it is emphasised that the low CSF vasopressin concentration in these patients might be only a nonspecific phenomenon due to the diffuse loss of cells within the central nervous system.

Topics: Adult; Aged; Dementia; Female; Humans; Hydrocephalus; Hydrocephalus, Normal Pressure; Male; Middle Aged; Vasopressins

We have studied plasma and cerebrospinal fluid vasopressin (CSF-AVP) and osmolality in 28 patients with cervical or lumbar pain syndromes (control patients), 11 patients with normal pressure hydrocephalus (NPH) and in 5 patients with benign intracranial hypertension (BIH). Vasopressin concentration in lumbar CSF to a high extent reflected the actual ventricular CSF-AVP concentration. In all groups CSF-AVP was lower than plasma AVP. Mean CSF-AVP in the control group was 1.3 pg/ml +/- 0.1 (SEM). In the NPH patients, who all suffered from severe dementia, CSF-AVP level was not different from that found in the control group (1.4 pg/ml +/- 0.2). In contrast to the findings in the two other groups CSF osmolality in BIH patients was higher than plasma osmolality (P less than 0.0). CSF-AVP in the BIH patients, characterized by an elevated intracranial pressure (ICP), was higher than in the control group (2.7 pg/ml +/- 0.4, P less than 0.001).

Topics: Adult; Aged; Cervical Vertebrae; Female; Humans; Hydrocephalus; Hydrocephalus, Normal Pressure; Lumbar Vertebrae; Male; Middle Aged; Osmolar Concentration; Pain; Pseudotumor Cerebri; Syndrome; Vasopressins

Topics: Adult; Affective Symptoms; Aged; Behavior; Brain Diseases; Depression; Hormones, Ectopic; Humans; Hydrocephalus, Normal Pressure; Hypothyroidism; Male; Neurocognitive Disorders; Nutrition Disorders; Psychotherapy; Psychotropic Drugs; Risk; Suicide Prevention; Thinking; Vasopressins