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Case 29 - A Man with Urinary Incontinence and Trouble Walking

Published online by Cambridge University Press:  09 January 2021

Pedro Rosa-Neto
Affiliation:
McGill University, Montréal
Serge Gauthier
Affiliation:
McGill University, Montréal
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Summary

A 71-year-old man was admitted for gradually difficult walking for 3 years along with memory impairment and urinary incontinence for 1 year. At first, this patient just complained of weakness while walking and dizziness. He was treated for arterial hypertension; however, no relief was obtained. He experienced more difficulties in walking and initiating steps. Besides these symptoms, his memory and thinking ability declined. His wife found that he responded slowly with personality change from a talkative and considerative gentleman to a silent man with apathy. The patient often felt urinary urgency, sometimes with incontinence. It was considered as symptoms of prostate hypertrophy. He was referred to a neurologist and MRI reported some lacunar infarctions and brain atrophy (retrospectively, lateral ventricles enlargement already existed). His Mini-Mental State Examination (MMSE) score was 18 points. Lumbar puncture (LP) was performed and cerebrospinal fluid (CSF) results were normal. The patient was diagnosed as having vascular dementia, hypertension and treated with neuroprotective agents and antihypertensives. After hospitalization, his symptoms were temporarily and partially relieved. His MMSE score was improved to 24 points when he was discharged.

Type
Chapter
Information
Case Studies in Dementia
Common and Uncommon Presentations
, pp. 127 - 131
Publisher: Cambridge University Press
Print publication year: 2021

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References

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Ishikawa, M, Hashimoto, M, Kuwana, N, et al. Guidelines for management of idiopathic normal pressure hydrocephalus. Neurol Med Chir. 2008;48:123.Google ScholarPubMed

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