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November 1973

Presenile DementiaClinical Aspects and Evaluation of Cerebrospinal Fluid Dynamics

Arch Neurol. 1973;29(5):299-308. doi:10.1001/archneur.1973.00490290039003

Data from 30 patients with presenile dementia are reported regarding history, clinical findings with special assessment of mental status; electroencephalography; and cerebral blood flow for ten patients with histological Alzheimer disease, five patients with other histological findings, ten patients with clinically suspected Alzheimer disease, and five patients with communicating hydrocephalus following meningeal irritation. Cerebrospinal fluid (CSF) dynamics were evaluated by pneumoencephalography, iodinated serum albumin (RISA) cisternography, and CSF infusion. Pneumoencephalography and cisternography were misleading. The CSF infusion test with fewer false positives was also not diagnostic by itself, thus emphasizing that diagnosis ultimately depends on histology. Ventriculosystemic shunting was beneficial chiefly in patients with communicating hydrocephalus consequent to postmeningeal irritation.