A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt

Background and importance: Pseudobulbar affect (PBA) is characterized by sudden, uncontrollable laughing, crying, or both in the absence of an appropriate triggering stimuli. Usually due to an underlying neurological condition, PBA has been reported less commonly in traumatic brain injury (TBI) and...

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Main Authors: Michael J. Gigliotti, Pardis Pooshpas, Neel Patel, Elias B. Rizk
Format: Article
Language:English
Published: Elsevier 2021-03-01
Series:Interdisciplinary Neurosurgery
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214751920304771
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author Michael J. Gigliotti
Pardis Pooshpas
Neel Patel
Elias B. Rizk
author_facet Michael J. Gigliotti
Pardis Pooshpas
Neel Patel
Elias B. Rizk
author_sort Michael J. Gigliotti
collection DOAJ
description Background and importance: Pseudobulbar affect (PBA) is characterized by sudden, uncontrollable laughing, crying, or both in the absence of an appropriate triggering stimuli. Usually due to an underlying neurological condition, PBA has been reported less commonly in traumatic brain injury (TBI) and patients with normal pressure hydrocephalus (NPH). This case documents the successful management of a male patient with PBA and post-traumatic NPH with ventriculoperitoneal shunt placement. Clinical presentation: An 88-year-old male initially presenting with acute right subdural hematoma after a fall underwent right decompressive hemicraniectomy and cranioplasty. On 2-month follow-up, the patient was diagnosed with PBA as well as post-traumatic hydrocephalus, confirmed with Center for Neurologic Study – Liability Scale (CNS-LS) questionnaire as well as a cerebrospinal fluid tap test (CSF-TT), respectively. The patient underwent ventriculoperitoneal shunt placement with successful resolution of PBA and post-traumatic NPH. Conclusion: A select subset of patients presenting with post-traumatic NPH may demonstrate successful resolution of PBA symptoms following surgical intervention to address the underlying neurological disorder potentiating pseudobulbar affect.
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spelling doaj.art-a73d386200ff4892a4ff728e1e95a3852022-12-21T23:21:48ZengElsevierInterdisciplinary Neurosurgery2214-75192021-03-0123100916A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shuntMichael J. Gigliotti0Pardis Pooshpas1Neel Patel2Elias B. Rizk3Department of Surgery, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United States; Corresponding author at: Penn State Health Milton S. Hershey Medical Center, Department of Surgery, 500 University Drive, Hershey, PA 17033, United States.College of Medicine, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United StatesDepartment of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United StatesDepartment of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United StatesBackground and importance: Pseudobulbar affect (PBA) is characterized by sudden, uncontrollable laughing, crying, or both in the absence of an appropriate triggering stimuli. Usually due to an underlying neurological condition, PBA has been reported less commonly in traumatic brain injury (TBI) and patients with normal pressure hydrocephalus (NPH). This case documents the successful management of a male patient with PBA and post-traumatic NPH with ventriculoperitoneal shunt placement. Clinical presentation: An 88-year-old male initially presenting with acute right subdural hematoma after a fall underwent right decompressive hemicraniectomy and cranioplasty. On 2-month follow-up, the patient was diagnosed with PBA as well as post-traumatic hydrocephalus, confirmed with Center for Neurologic Study – Liability Scale (CNS-LS) questionnaire as well as a cerebrospinal fluid tap test (CSF-TT), respectively. The patient underwent ventriculoperitoneal shunt placement with successful resolution of PBA and post-traumatic NPH. Conclusion: A select subset of patients presenting with post-traumatic NPH may demonstrate successful resolution of PBA symptoms following surgical intervention to address the underlying neurological disorder potentiating pseudobulbar affect.http://www.sciencedirect.com/science/article/pii/S2214751920304771Pseudobulbar affectNormal pressure hydrocephalusVentriculoperitoneal shunt
spellingShingle Michael J. Gigliotti
Pardis Pooshpas
Neel Patel
Elias B. Rizk
A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt
Interdisciplinary Neurosurgery
Pseudobulbar affect
Normal pressure hydrocephalus
Ventriculoperitoneal shunt
title A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt
title_full A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt
title_fullStr A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt
title_full_unstemmed A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt
title_short A male patient with pseudobulbar affect caused by post-traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt
title_sort male patient with pseudobulbar affect caused by post traumatic normal pressure hydrocephalus successfully managed with ventriculoperitoneal shunt
topic Pseudobulbar affect
Normal pressure hydrocephalus
Ventriculoperitoneal shunt
url http://www.sciencedirect.com/science/article/pii/S2214751920304771
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