Normal pressure hydrocephalus

Background

• Possible reversible cause of dementia
• CSF buildup in the ventricles leading to increased intracranial pressure with edema of the periventricular white matter and corona radiata
  • Sacral motor nerve fibers that produce gait instability; incontinence ensues when compressed

Clinical Features

• Gait disturbance
• Memory loss
• Incontinence

Differential Diagnosis

• Alzheimers
• Stroke
• Parkinson's Disease
• Electrolyte abnormality
• Malignancy
• Uremic encephalopathy
• Hydrocephalus ex vacuo (diffuse cerebral atrophy on CT)

Diagnosis

• CBC
• Chem 7
• LP: normal opening pressure
  • Symptom improvement supports diagnosis
• CT brain

Management

• Additional work up warranted for surgical candidate
• Assessment for Surgical CSF shunting

Also See

• Stroke (Main)
• Ataxia
• Parkinson's Disease