Clinical manifestations and neuroanatomical correlates of reversible impairment of cognitive functions in patients with normotensive hydrocephalus: Case Report

From a neuropsychological perspective, normotensive hydrocephalus NPH is characterized by cognitive impairment associated with the compression exerted by ventricular dilatation on the cingulate cortex and fronto-striatal circuits. The Rey-Osterrieth Complex Figure Test (ROCFT) is a neuropsychological assessment measure widely used by clinicians and researchers because of the wide variety of cognitive information it allows to estimate. We present the case of young male patient with refractory structural epilepsy secondary to a childhood brain injury resulting from a metastasis of a renal tumor. Referred to Neuropsychology for behavioral changes and cognitive impairment; presenting atypical performance in the copying phase of the ROCFT. Failures in visual integration and coding of the ROCFT copy show that, in cases of NPH, brain structures such as the cerebellum and posterior cingulum can also be compromised by the compression exerted by the cerebral hemispheres as they move due to ventricular dilatation. Failures in integration, planning, rotation and displacement of ROCFT elements have been reported in patients with secondary psychotic conditions and posterior cingulate tumors. Failures in visual integration associated with NPH may be related to the involvement of more postero-caudal brain structures such as the cerebellum and posterior cingulum or to secondary psychosis.