As we wrote earlier, it's suddenly unclear if my neurological issue is Alzheimer's disease or normal pressure hydrocephalus (NPH) - or both. NPH is often misdiagnosed as Alzheimer's disease, but also, the two disease often occur together. Thirty percent of NPH patients also have Alzheimer's disease.
Tomorrow morning, I have an appointment for a consult with a neurosurgeon in Walla Walla. Walla Walla is about an hour's drive from here. The purpose of the visit is to lean on his experience with cognitive and balance-impaired patients to see if it's appropriate for me to receive a shunt. The high volume spinal tap I had in December suggests that it would be, but my neurologist cautions that there are many potential surprises here. She wanted me to see an experienced neurosurgeon to find out what his experience says about my scenario.
One thing I want to discuss with him is the changes in my computed hippocampus volumes. The evidence is that the normalized values for men my age went down from 2015 to 2017, stayed steady to 2018, but then improved remarkably into 2021. My ventricle volumes remained unnaturally enlarged throughout this time. NPH would explain my ventricle volumes, but not the changes in hippocampus volumes. Alzheimer's disease could be responsible for hippocampus changes from 2015 to 2017, and lifestyle changes could explain the hippocampus changes from 2017 to 2021. Or that's how it looks to my uneducated eye.
I'll know more tomorrow. I hope.
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