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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
ANAESTHETIC MANAGEMENT OF CASE OF NORMAL PRESSURE HYDROCEPHALOUS FOR FRACTURE FEMUR SURGERY
Author
Sandhya Gujar*, Tejas Bhandari, Letkhohao Haokip
Email
drsandhyagujar@gmail.com
keyword
NPH, Spinal Anaesthesia.
Abstract
Normal pressure hydrocephalus is a neurological condition in which there is dilatation of cerebral ventricles with pressure effects on nearby brain tissue. It is chronic disorder often misdiagnosed as Alzheimer’s disease or dementia. This patient of 72 yrs age was admitted with medical complaints of altered orientation, instability in gait and electrolyte imbalance with urinary incontinence he also had h/o HT/IHD with 2D ECHO showing hypokinesia, EF% of 30 %. Patient had uncontrolled diabetes, respiratory tract infection patient had fall in ward and developed fracture neck femur which required surgery immediately. After thorough investigation with MRI and neurological opinion patient was diagnosed to have normal pressure hydrocephalus. As treatment for NPH is to remove large quantities of CSF and it was necessary to maintain ICP it was decided to give spinal anaesthesia after removal of CSF of equal volume in order to maintain CSF pressure. Noninvasive method of monitoring as EEG, BIS, CVP, and arterial pressure was done. Patient was successfully managed throughout perioperative period.
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