This report describes a 70-year-old man with obstructive sleep apnea who deteriorated rapidly when nasal continuous positive airway pressure was begun. The patient was found to have normal-pressure hydrocephalus, which was possibly exacerbated by the nasal continuous positive airway pressure. A review of the literature indicates several significant associations between apnea, normal-pressure hydrocephalus, and increased intracranial pressure and suggests that the association of obstructive sleep apnea and hydrocephalus might not be rare. Implications for diagnosis and treatment are discussed. (J Geriatr Psychiatry Neurol 1992;5:238–240).
Get full access to this article
View all access options for this article.
References
1.
1. McNamara ME: Detection of sleep apnea during standard ambulatory cassette EEG recording for seizures: Two case reports. Clin Electroencephalogr1990; 21:168–169.
2.
2. Casmiro M, Benassi G, Cacciatore FM, D'Alessandro R: Frequency of idiopathic normal pressure hydrocephalus, letter. Arch Neurol1989; 46:608.
3.
3. Phillips B, Cook Y, Schmitt F, Berry D: Sleep apnea: Prevalence of risk factors in a general population. South Med J1989; 82:1090–1092.
4.
4. Kuchiwaki H, Takada S, Ishiguir H, et al: Pressure wave with apnea evaluated by sleep level in patient with ventricular dilatation. Neurol Res1988; 10:105–111.
8. Lodrini S, Montolivo M, Pluchino F, Borroni V: Positive end-expiratory pressure in supine and sitting positions: Its effect in intrathoracic and intracranial pressures. Neurosurg1989; 24:873–877.
9.
9. Pasterkamp H, Cardoso ER, Booth FA: Obstructive sleep apnea leading to increased intracranial pressure in a patient with hydrocephalus and syringomyelia. Chest1989; 95:1064–1067.
10.
10. Rockoff MA, Ropper AH: Treatment of intracranial hypertension, in Ropper AH, Kennedy SK, Zervas NT (eds): Neurological and Neurosurgical Intensive Care. Baltimore, University Park Press, 1983, p 21–37.
