Résumé
Normal pressure hydrocephalus is usually observed with the clinical triad urinary incontinence, gait disturbance and cognitive impairment. However, this clinical triad is rarely seen in patients during rehabilitation. Brain damaged people (due to ischemic or hemorrhagic strokes, brain injuries) present insidious symptoms. Radiologic and hydrodynamics tools have been developed in the past years but the gold standard is still to this day to shunt. We investigated a restrospective monocentric study to describe the diagnostic criterias, the functional evolution and secondaries complications. We also aimed to do a review of the litterature. We followed 19 patients, 10 shunted prior to rehabilitation and 9 who were shunted during rehabilitation. 94% were improved after shunt: 90% cognitively, 58% regarding urinary symptoms, 79% their gait and 94% their balance. 22% are independant, 72% live with partial aid with 15% living in an institution. Complications (valves or pressure modifications) seemed to be more often observed in the subgroup already shunted (70% vs 60%). Subarachnoid hemorrhage and external ventricular derivation during reanimation seem to be risk factors. Functional benefit is important despite 53% of complications. These data are confirmed by the litterature. Some supplementary studies are needed to standardize the diagnostic criterias with clinical combined scales, associated with functional imagery (PET scanner) and hydrodynamic tests. Better diagnosis should lead to treatment with, sometimes, a spectacular functional benefit.