A year and a half ago, mom was diagnosed with Alzheimer’s by a neurologist who was leaving the practice and moving. Since that time, mom's dementia has advanced to moderate/moderate late stage (probably stage 5.) Mom had an MRI back then and I remember the neurologist mentioning the possibility that her dementia could be caused by normal hydrocephalus (fluid on the brain) instead of Alzheimer’s. Unfortunately, there was no neurologist nearby to take her to after this one moved out of the area, so she hasn't been back to a neurologist since. However, I recently heard there is now a neurologist back in our area again.
I was recently researching Alzheimer’s and ran into an article that mentioned hydrocephalus and how sometimes dementia can be reversed if a shunt is installed. I had an "ah-ha" moment and all mom's symptoms seem to line up with hydrocephalus. Now I am trying to hold onto to hope that all of this horrible memory loss and damage could be reversed. But I would have to take her back to a neurologist to re-diagnose her again, do an MRI, and other invasive procedures. The last MRI she had done was very hard on her and she told me she never wanted to do it again. Now, a year and a half later, it would be even harder. She is incontinent, frail, walks with a walker, gets nauseated quickly from medical procedures, and is a fall risk. She knows all of us, but her short-term memory is nearly gone. Has anyone had a relative with this condition who has had success with a shunt procedure? My understanding is that the surgery is an hour long and the recovery period is several days in the hospital. This would be very hard one her. Yet, if her dementia could be reversed, it would be incredible! Am I holding out hope in vain? If you were in my shoes, would you take her to a neurologist for a second opinion?
Hydrocephalus: Causes, Symptoms, and Treatment (webmd.com)
Your post taught me a new term. I could not see how hydrocephalus could be "normal" but indeed it is a "thing" not uncommon to some older adults. Information below is from of webMD:
The brain 'dries out' as it ages, and the space is filled with cerebral-spinal fluid. This can cause too much pressure on the brain, but in normal situations, it's not really a problem.
My son had a epithelial cyst in his brain following a 2 year church mission to Brazil.
He had massive migraines almost constantly and the only thing that helped was to have a spinal tap with amazing amounts of excess fluid drained off. Eventually he had a surgery, which removed the cyst. The dr said he would ALWAYS have this huge 'space' in his brain, but was proven wrong as his young brain recovered from the surgery. No signs now of anything wrong.
A year later he had a shunt implanted in his brain and he has been fine since. He was 22--so youth was in his favor.
I hate to be a negative Nellie, but probably the BEST you can hope for is a slowing of the dementia and perhaps a return of some cognitive function.
The good news is, the shunt surgery was a one night stay in the hospital.
It's a LOT to put an aged person through and while I sure admire your hopes--please don't get too excited about this being a 'cure'.
Also--if tests are grueling for her to endure, be sure the drs know that and can offer her meds to help her be calm through any procedures. Be her advocate.
I truly wish you luck. Wouldn't it be great if this were truly a big change in her life.
That said, I'm not sure what you have to lose by taking her to the neurologist, having him review her MRI, and asking him about a shunt. Explain that she won't lie still for another MRI. I think it's worth investigating. Just manage your expectations.
Someone else asked this same question within the last couple of days. I said then a woman from Church suffered from it and had a shunt. It did not reverse her problem and it didn't cure it. She worsened as time went on and ended her days in LTC because her 80 yr old husband could not care for her.
"Normal pressure hydrocephalus can sometimes be treated with surgical insertion of a shunt, a long, thin tube that drains excess CSF from the brain to the abdomen. Surgery is most likely to help correct difficulties walking, but thinking changes and loss of bladder control are less likely to improve."
Loss of function may not come back
Shunts are done for severe conditions for lots of fluid frequently associated with reduction of consciousness
Shunts can slip out of place and require surgical revisions.
I doubt that you will be successful finding that this can be done.
You don't give your mother's age. We use a geriatrician and she explained to me that with my husband's condition (he is 75) many procedures that may be recommended are no longer appropriate for him because of all his health issues. So she often asks me, if we do the test and it is positive... what would we do differently? Right now he has a hernia and the cardiologist won't clear him for any surgery with general anesthesia ever again unless it is life threatening emergency. The surgeon said for the surgery, he needs all the muscles relaxed and will not do it with any other type of anesthesia. My mother (at about 60) had been told the same thing but later required surgery for an aortic aneurysm and while it was hard on her, it saved her life and she lived about another six years. So my heart goes out to you as you make caregiving decisions, but know anything you do out of love for your mom is never wrong.
Eventually, the car breaks down and we're faced with giving up or reinvesting in what is left. Do we repair the brakes when the engine needs replacement?
I'm not a big fan of putting older people through a lot of tests and surgeries, but this sounds like it's worth exploring because it could improve her quality of life.
However, if it will ease your mind to get a second opinion, then do so. A decent Dr will tell you if it’s worth looking into or if she’s too frail to handle surgery.
Dementia often makes loved ones keep looking for a cure, or something to make things better. Sadly, there usually isn’t anything.
How would you feel if a Dr told you it’s too late for her now, but a year ago it may have helped her. Seeking answers won’t necessarily make you feel better.
Do what you feel is best for her in your heart.