# Long-Standing Overt Ventriculomegaly in Adults (LOVA): Can You Blame Alcohol?

## TL;DR

A 34-year-old man with chronic alcoholism showed severe brain ventricle enlargement, diagnosed as LOVA, and was treated with drugs and thiamine.

## Contribution

This case report links chronic alcoholism to LOVA, a condition typically associated with early-onset hydrocephalus.

## Key findings

- The patient had severe ventriculomegaly with an Evans' index of 0.40.
- Clinical symptoms were less severe than MRI findings.
- Conservative treatment with hyperosmolar drugs and thiamine was effective.

## Abstract

Long-standing overt ventriculomegaly in adults (LOVA) is a kind of chronic hydrocephalus that has been reported to have started in infancy and is characterized by severe ventriculomegaly and macrocephaly. It often manifests clinically in later adulthood. We describe the case of a 34-year-old male patient who had a history of chronic alcoholism and who had been complaining of headaches, disturbed gait, and frequent falls for three months when he arrived in a stupor at the emergency room. Massive ventriculomegaly with Evans' index of 0.40 was found during a head magnetic resonance imaging (MRI). The MRI results were more severe than the clinical manifestations. He was diagnosed with LOVA and treated with conservative hyperosmolar drugs, neuroprotective agents, and intravenous (IV) thiamine. The patient was discharged and consented to follow-up after a hospital stay of seven days.