Hakim–Adams syndrome in a middle-aged patient: description of a clinical case of resistant hydrocephalus
CLINICAL CASE
Abstract
Hakim–Adams syndrome (idiopathic normotensive hydrocephalus) is a rare disease characteristic of elderly patients and presents significant difficulties for diagnosis and treatment. The aim is to describe a unique clinical case of hydrocephalus resistant to standard therapy with a complete Hakim–Adams triad in a young patient. A detailed description of the case of a 43-year-old patient with occlusive hydrocephalus, which later transformed into a resistant form of Hakim-Adams syndrome, is presented. The data of multiple dynamic MRI and CT scans of the brain are presented, reflecting the ineffectiveness of successive surgical interventions: ventriculoperitoneal bypass surgery, endoscopic triventriculostomy, and revisions of the bypass system. Despite aggressive multi-stage treatment, which included all major types of surgical interventions, it was not possible to achieve stable remission of the disease. The case demonstrates pronounced resistance to treatment and rapid disease progression in a young patient, aggravated by concomitant HIV infection. This observation highlights the need for a comprehensive interdisciplinary approach and the search for new treatment strategies for resistant forms of hydrocephalus that do not fit into the classical framework of Hakim–Adams syndrome.
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