Priya Kadam

Royal Infirmary of Edinburgh, UK

Title: A curious case of Normal Pressure Hydrocephalus after Traumatic Brain Injury

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Biography

Priya Kadam is a Junior Clinical Fellow (medic) working in neurosurgery, with a background in Neuroscience MSc and Psychology BSc. She approaches clinical problems holistically, understanding the science behind it as well as being involved in the daily management of neurosurgical elective and emergency conditions. Her research interests include holistic treatment for grade 4 brain tumour glioblastoma, immune mediated management for traumatic brain injury and Psycho Oncology. She has studied and worked in a number of UK institutions, including London, Plymouth, Birmingham and Edinburgh. 

Abstract

A 67-year-old male sustained a traumatic brain injury and subsequently developed headaches and anxiety, which were attributed to his post-concussion state. He had further problems with his memory, issues concentrating and difficulty mobilising. He underwent a period of neurorehabilitation in the community, however he remained symptomatic and developed severe urinary incontinence, filling 6 urinary bottles per night. 

After being referred to Neurology, the patient had a CT head and MRI which demonstrated ventriculomegaly, cortical atrophy and a diagnosis of normal pressure hydrocephalus was made. He underwent a lumbar puncture, which had no therapeutic effect and no abnormality detected. Curiously, a ventriculoparietal shunt (VPS) had a positive effect and the patient’s symptoms vastly reduced. An additional diagnosis of functional neurological disorder was made to the normal pressure hydrocephalus. He has since improved in mobility on follow up but has unexplained photophobia. A question was raised as to whether this may be a placebo effect of the VPS.