Can dementia be cured?
Dementia is not a single disease. Cognitive impairment due to some causes can be reversible. For example:
• Vitamin B12 deficiency
• Thyroid hormone disorders
• Normal Pressure Hydrocephalus (Adams–Hakim disease) — when properly treated — may show improvement in cognitive functions.
What proportion of dementias is due to Normal Pressure Hydrocephalus?
Studies indicate that Normal Pressure Hydrocephalus accounts for approximately 5% of all dementia cases. Its key feature is that it is a potentially treatable cause of dementia.
What are the typical symptoms of Adams–Hakim disease?
(Classic triad):
- Gait disturbance (small steps, shuffling gait)
- Recent memory and attention problems
- Urinary incontinence or unawareness of the need to urinate
Gait disturbance is usually the earliest symptom.
How does it differ from Alzheimer’s disease?
In Normal Pressure Hydrocephalus:
• Memory loss is usually milder and more slowly progressive,
• Severe cortical signs such as marked language disturbance or agnosia are often absent,
• There is a chance of clinical improvement with proper treatment
This condition may occur together with other intracranial problems such as hemorrhage, tumor, infection, or head trauma, or it may arise spontaneously (idiopathic).
How is Normal Pressure Hydrocephalus evaluated?
- Detailed history and neurological examination
- Cognitive tests (such as the Mini-Mental State Test)
- Brain MRI
- Lumbar puncture or temporary CSF drainage to observe clinical response
Demonstrated improvement with this tests increases the likelihood of benefit from surgical treatment.
Can dementia be stopped?
If the cause of dementia is Normal Pressure Hydrocephalus, disease progression can be halted, and some patients may experience reversal of symptoms.
What is the success rate of shunt surgery?
According to various series:
• About 60% of patients show marked early clinical improvement after shunt placement,
• Sustained and meaningful improvement in the long-term occurs in about 25–35%,
• The recovery process may extend up to four months.
One of the most important factors affecting success is shorter symptom duration (often less than 6 months).
How does shunt treatment work?
Answer: Shunt systems are valve-and-tube devices that divert excess CSF from the brain to the abdominal cavity in a controlled manner. The goal is to balance pressure and improve gait, urinary control, and cognitive functions. Shunts can remain in the body long term; if malfunction occurs, replacement may be required.