Report about a case of hydrocephalus mistaken for 'mental illness' (washingtonpost.com)

The original title of this link is “She was headed to a locked psych ward. Then an ER doctor made a startling discovery”, which doesn’t describe the article very well. My substitute title attempts to capture the essence of the piece.

I noticed this link on https://www.madinamerica.com/2022/02/headed-locked-psych-war...

The important part of the article:

  But something indefinable — [emergency physician Elizabeth] 
  Mitchell characterized it as “maybe gut instinct” honed by nearly 
  two decades of practice — prompted her to order a CT scan of 
  Chloe’s head to better assess her mental status. […]

  Chloe had a life-threatening condition that Mitchell characterized 
  as “the most severe case of hydrocephalus I’ve ever seen.” She 
  needed brain surgery as soon as it could be scheduled and was 
  being sent to the neuro-ICU at Cedars-Sinai.  

  Hydrocephalus, popularly known as “water on the brain,” is 
  caused by the accumulation of cerebrospinal fluid in cavities 
  known as ventricles. Spinal fluid, which cushions the brain, is 
  critically important to a wide variety of brain functions. Excess 
  fluid was compressing the brain’s frontal lobes — responsible 
  for memory, decision-making and emotion — against the inside 
  of Chloe’s skull because it could not be reabsorbed. Without 
  treatment, hydrocephalus, which can be present at birth or occur 
  later in life, can cause brain damage, coma or death.

  Alison had never heard of hydrocephalus. And Chloe, she told 
  Mitchell, had never undergone brain imaging.

  Mitchell mentioned the diagnostic mnemonic she had learned in 
  medical school; “wet, wobbly and wacky.” She was incredulous 
  as Alison ticked off telltale symptoms of hydrocephalus, many of 
  which dated back years: poor balance, gait problems, personality 
  changes, confusion, fainting, memory lapses and involuntary 
  urination.

  “I cannot believe that no one ever ordered a CT scan,” Mitchell 
  said. “That’s what I thought was very weird.”

I’m posting something on Mad In America on Thursday where I say that there are always causes behind supposed cases of “mental illness”, and psychiatrists should work harder to figure out what’s going on in their patients.

Chloe’s case of hydrocephalus probably started when she was a child. It wasn’t caught, not even when overt symptoms started to develop. If she’d been sent to the psych hospital, she never would have recovered.