This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
A 72-year-old male science teacher with normal pressure hydrocephalus presented 1 year after ventriculoperitoneal (VP) shunt placement with neck pain, behavioral changes, and nonamnestic cognitive decline. Six months prior, his shunt was adjusted from 4 to 3. Montreal Cognitive Assessment was 21/30 with dysexecutive predominance. EEG was unremarkable. CSF Alzheimer disease biomarkers were borderline. MRI (Figure 1) found overshunting. After shunt adjustments (3–4), his cognitive and behavioral symptoms resolved. Repeat Montreal Cognitive Assessment after 4 months was 29/30 with sustained remission after 1 year. Intracranial hypotension, whether from VP shunting or spontaneous CSF leak,1,2 may cause reversible dysexecutive cognitive impairment.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
Submitted and editor reviewed. The handling editor was Editor-in-Chief José G. Merino, MD, MPhil, FAHA, FAAN.
- Received March 10, 2022.
- Accepted in final form May 19, 2022.
- © 2022 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
