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Hydrocephalus and Headaches in Paget’s Disease of the Skull: Complete Relief by Ventriculo-Atrial Shunt

Published online by Cambridge University Press:  18 September 2015

Chantal Hausser
Affiliation:
Divisions of Neurology, Neurosurgery and Radiology, Hôtel-Dieu de Montréal and Université de Montréal
Georges Elie Ouaknine
Affiliation:
Divisions of Neurology, Neurosurgery and Radiology, Hôtel-Dieu de Montréal and Université de Montréal
Jacques Sylvestre
Affiliation:
Divisions of Neurology, Neurosurgery and Radiology, Hôtel-Dieu de Montréal and Université de Montréal
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Summary

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A 76 year old patient with a long history of headaches was found to have Paget’s disease and communicating hydrocephalus. There were (otherwise) no neurological or musculo-skeletal manifestations of Paget’s disease, but moderate impairment of intellectual function was present. Treatment with disphosphonates did not bring any significant improvement, but three days following a ventriculo-atrial shunting procedure, the patient became headache-free for the first time in several years.

In the literature, patients with hydrocephalus have been shown to respond quite unevenly to atrio-ventricular shunting, but in most instances the descriptions concerned advanced cases with well-established symptoms of dementia, ataxia and incontinence. Our case is reported to stress the importance of early diagnosis and management of hydrocephalus in Paget’s disease for the prevention of widespread neurological dysfunction.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1984

References

Alexandre, C., Trillet, M., Meunier, P., Fisher, C. (1979) Traitement des paraplégies pagétiques par les disphosphonates. Rev. Neurol. 135:89, 625632.Google Scholar
Botez, Mi., Bertand, G., Leveille, J., and Marchand, L. (1977). Parkinsonism-dementia complex, hydrocephalus and Paget’s disease. Can. J. of Neurol. Sci. 4:139142.CrossRefGoogle ScholarPubMed
Boudin, G., les Besnerais, Y., Goldewski, S., Fabiani, J.M. (1975). Les complications neurologiques des impressions basilaires pagétiques et leur traitement chirurgical. Sem. Hop Paris. 51:145155.Google Scholar
Bull, J.W.D., Nixon, W.L.D., Pratt, R.T.C., Robinson, P.K. (1959). Paget’s disease of the skull and secondary basilar impression. Brain. 82:1022.CrossRefGoogle ScholarPubMed
Culebras, A., Feldman, R.G., Fager, C.A. (1974). Hydrocephalus and dementia in Paget’s disease of the skull. Journal of Neurol. Sci. 23:307321.CrossRefGoogle ScholarPubMed
Detilleux, M., Guillausseau, P.J., Caquet, R., Reynard, M., Metzger, J. (1977). Maladie de Paget avec hydrocéphalie obstructive et état mémentiel. Evolution favorable sous l’effet d’un traitement par la calcitonine. Ann. Med. Intern. 128:89, 667672.Google Scholar
Downey, R.Siris, E.S., Antunes, J.L. (1980. “Crocodile Tears” and Paget’s disease: Case report. Neurosurgery. 7:621622.CrossRefGoogle ScholarPubMed
Goldhammer, Y., Braham, J., Kosary, I.Z. (1979). Hydrocephalic dementia in Paget’s disease of the skull: Treatment by ventriculoatrial shunt. Neurology 29:513516.CrossRefGoogle ScholarPubMed
Hann, R.G. (1910). A case of osteitis deformans terminating with cerebral symptoms. Brit. Med. J. 1:135137.CrossRefGoogle ScholarPubMed
Hens, L., van den Bergh, R. (1979). Hydrocephalus-dementia-complex in Paget’s disease. Clin. Neurol. Neurosurg. 81:4.CrossRefGoogle ScholarPubMed
Hubault, A., Bourgeois, P. (1975). Les complications neurologiques de la maladie de Paget. Rev. Rhum. 42(10):563571.Google Scholar
Riser, M., Gayral, G., Lazorthes, G., Hivert, M. (1948). Etat mélancolique grave au cours d’une maladie osseuse de Paget à localisation crânienne exclusive. Ann. Med. Psych. 2:6976.Google Scholar
Schmidek, H.H. (1977). Neurological and neurosurgical sequelae of Paget’s disease of bone. Clin. Orthop. E. Rel. Res. 127:7077.Google Scholar
Taylor, A.R., Chakravorty, B.C. (1964). Clinical syndromes associated with basilar impression. Arch. Neurol. 10:475484.CrossRefGoogle ScholarPubMed