Dementia Is Reversible in Certain Cases

Nov. 18, 2005 — -- As she got older and started having problems walking, Joy Cotrell thought she was headed for a wheelchair and a room in a nursing home.

"I could not walk without holding on," Cotrell said. "Then I graduated to a cane."

Like many others in her situation, Cotrell worried it was the early signs of Alzheimer's or Parkinson's disease. But a visit to a doctor revealed something unexpected: adult-onset "normal pressure hydrocephalus," or an accumulation of cerebrospinal fluid.

For unknown reasons, this condition predominantly affects older adults, according to the Hydrocephalus Association. As fluid builds up in the brain, it stretches nerve tissues, causing difficulty walking, dementia and in later stages, incontinence, which are symptoms usually associated with Alzheimer's and Parkinson's diseases.

Sometimes a brain disease like meningitis can spur the condition, but it often has no known cause, doctors say. It is responsible for about 5 percent of all dementia cases, according to the National Library of Medicine.

"It's not a condition that is commonly seen and it's probably under-diagnosed," said Dr. Arthur Dick, a neurology professor with the University of Kansas Medical Center.

But unlike more common causes of dementia, hydrocephalus often can be controlled. Cotrell underwent a surgical procedure to have a drain-like shunt placed in her brain.

"It drains the fluid into the abdominal cavity," Dick said.

The Hydrocephalus Association says that shunting success rates vary, depending on how early the condition is detected and whether the shunting is done at a clinic with advanced diagnostic equipment.

It quickly became apparent that her shunt was a success, Cotrell said.

"The next day, with a nurse beside me, I could walk without holding on," she said.

ABC affiliate KBMC in Kansas City contributed to this report.