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Salomón Hakim and the Discovery of NormalPressure Hydrocephalus

Wallenstein, Matthew B. MD; McKhann, Guy M. II MD

doi: 10.1227/01.NEU.0000370058.12120.0E
Historical Library

INTRODUCTION: Normal-pressure hydrocephalus (NPH) is a chronic neurological disorder characterized by enlarged ventricles and a triad of clinical symptoms affecting gait, cognition, and urinary continence. Salomón Hakim first identified the syndrome in 1957 at the Hospital San Juan de Dios in Bogotá, Colombia. Even after decades of international focus and thousands of publications on his disorder, Hakim's story remains largely untold.

METHODS: In this historical review, we explore the discovery of NPH through a series of personal interviews with Professor Hakim and his family, discussions with former colleagues, and review of the relevant medical literature.

RESULTS: Professor Hakim first published his thesis in 1964 and 6 case reports of NPH in The New England Journal of Medicine and the Journal of the Neurological Sciences in 1965. Hakim rose to the forefront of academic medicine as he described a newfound ability to reverse symptoms of “neurodegeneration” that had long been considered irreversible.

CONCLUSIONS: As we learn more about NPH, the fascinating story of Professor Hakim, the father of NPH, is of both historical relevance and current interest.

Department of Neurological Surgery, The Neurological Institute, Columbia University, New York, New York

Reprint requests: Guy M. McKhann II, MD, Department of Neurological Surgery, The Neurological Institute, Columbia University, 710 W 168th St, New York, NY 10032. E-mail:

Received, July 27, 2009.

Accepted, January 15, 2010.

Copyright © by the Congress of Neurological Surgeons