■本报告涉及一名70岁男性特发性正常压力脑积水(iNPH)的病例。目前病例的诊断需要2年多的时间。iNPH的特征是脑室肥大,具有已知的三联症状:步态障碍,认知障碍和尿失禁。尽管这是一个困难的诊断,必须排除其他条件,过程中的几个点可以导致正确的诊断。该报告的目的是确定诊断被推迟这么长时间的几个原因,以及未来的教训。
■该患者随着时间的推移出现了一些症状。首先,他表现出抑郁情绪和行为改变。他后来出现了步态困难,最后,尿失禁.多次咨询和检查未能为他的所有症状提供确切的解释。两年后,医院的一名新医生从头开始,认出了iNPH三合会,放射科医生证实了诊断.
■iNPH的诊断很困难,随着时间的推移,症状可能会显现出来。在这种情况下,诊断的延迟超出了估计。通过跨学科咨询获得更广阔的视野可以提供新的见解并导致更早的诊断。
UNASSIGNED: This report concerns the
case of a 70-year-old man with idiopathic normal pressure hydrocephalus (iNPH). The diagnosis in the current
case took more than 2 years. iNPH is characterised by ventriculomegaly with a known triad of symptoms: gait disturbance, cognitive impairments and urinary incontinence. Although this is a difficult diagnosis and other conditions must be ruled out, several points in the process could lead to a correct diagnosis. The aim of the report is to identify several reasons why the diagnosis was delayed for such a long time, as well as lessons for the future.
UNASSIGNED: This patient developed several symptoms over time. First, he presented with depressive mood and altered behaviour. He later developed gait difficulties and, finally, urinary incontinence. Multiple consultations and examinations failed to provide an exact explanation for all his symptoms. After 2 years, a new doctor at the hospital started from scratch and recognised the iNPH triad, and the diagnosis was confirmed by the radiologist.
UNASSIGNED: The diagnosis of iNPH is difficult, as symptoms may manifest over time. In this
case, the delay of diagnosis exceeded estimations. A broader view through interdisciplinary consultation could provide new insights and lead to earlier diagnosis.