Normal pressure hydrocephalus (NPH) is hydrcephalus with normal intracranial pressure. You must remember that majority of patient has no identifiable cause for NPH. It usually happens in elderly patients.
Clinical Presentations
Triad of GUD
Gait disturbances, Urinary incontinence and Dementia.
Investigations
Picture source: e-medicine (arrow- dilated ventricles)All investigations would be normal except CT/MRI head show non-obstructive hydrocephalus. PET scan mayshow hypometabolism.
Treatment
Ventricular shunting or lumbar puncture drainage of CSF
Tips for MRCP
1) Popular questions in MRCP are interpretation of CT brain, an elderly demented patient with urinary incontinence.
2) Remember that NPH is one of the important differential diagnosis of dementia!
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