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Deviations from the characteristic syndrome such as the occurrence of dementia without gait disorder or the presence of apraxias, aphasias, and other focal cerebral signs should lead one to a diagnosis other than NPH Fisher, on analyzing successfully shunted cases, noted that almost without exception gait disturbance was an early and prominent symptom Uncertainties of diagnosis increase with advancing age owing to the frequent association of degenerative dementia and vascular lesions However, in Fisher s experience, age alone does not exclude the existence of NPH as a cause of gait disorder, and long duration of symptoms does not preclude a salutary outcome from shunting.

In patients who are averse to the shunting procedure or who have medical conditions that make the surgery inadvisable, it is sometimes possible to produce a reasonable improvement in gait for several months by repeating the spinal puncture and drainage of large amounts of uid every few weeks or months The potential failure of shunting must be anticipated in patients who do not conform to the typical syndrome or whose disease has advanced to the stage of long-standing incontinence or dementia In some instances, a lack of improvement is explained by inadequate decompression, which justi es a revision of the shunt with a valve that drains at lower pressures Overdrainage, in contrast, causes headaches that may be chronic or orthostatic and may be associated with small subdural collections of uid.

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These uid collections, or hygromas, consisting of CSF and proteinacious uid derived from blood products, are generally innocuous and do not require drainage unless they enlarge or cause focal neurologic symptoms or, rarely, seizures Some surgeons prefer to insert an externally programmable valve that allows adjustments if the ventricles do not reduce in size or if the opposite, overdrainage, occurs Although shunting is relatively simple as a surgical procedure, it is associated with complications, the main ones being a postop-.

of the UpdatePanel container but inside the div container. Set its Text property to Original. Double-click each of the buttons to establish an event handler for each in the C# portion of the code.

: You can start signing the day your baby is born. However, many parents find it more convenient to start closer to the time when their baby is showing interest in communicating. How can you tell If your answer is yes to any of the following questions, now is a good time to start.

The 3DROTATE command allows you to rotate objects in 3D space. 1. Pick the 3D Rotate button on the Modify panel. 2. Select the box primitive and press ENTER. The Rotate gizmo appears. Like the Move grip tool, the Rotate grip tool consists of three axis handles and a center box. 3. Pick the front lower corner of the box as the base point. 4. In reply to Pick a rotation axis, move the F i g . 4 5 -3 crosshairs over the circular blue axis handle to highlight it. (It becomes yellow when it is highlighted.) A blue vector appears, as shown in Fig. 45-3. 5. Pick the axis while the blue vector is present. 6. Pick an endpoint on the box primitive as the angle start point; then rotate the box dynamically by moving the crosshairs in the drawing area. 7. Pick anywhere in the drawing area to complete the 3D rotation. 8. Experiment with the 3DSCALE command and the Scale gizmo on your own. 9. Erase the box primitive.

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When endocrine glands secrete their hormones at a normal (normo-) rate, we say that there is a normosecretion (NOR-moh-see-KREE-shun) of the hormones. Consider, for example, a normosecretion of insulin. In this case,

9. A small boat traveled ve miles upstream and later traveled back downstream. The stream s current was 4 mph, and the boat spent a total of 1 hour 40 minutes traveling. What was the boat s speed in still water (a) 5 mph 10. (b) 6 mph (c) 9 mph (d) 8 mph p 17 4

Storage groups are new to Exchange 2000 and provide a more flexible model of administering message and data storage than previous versions of Exchange. A storage group is a logical grouping of data stores that can be managed as a single administrative entity. To understand this concept more clearly, we need to explain the terminology used to describe the different storage components of Exchange.

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The Dead Gira e DISORDER TABLE for 19 (Key Text Facts About Biological Disorder Within An Organism)

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