Communicating hydrocephalus

Case contributed by A.Prof Frank Gaillard

Presentation

Unsteady and forgetful.

Patient Data

Age: 60 years
Gender: Female
Modality: CT

The ventricular system is disproportionately enlarged. No obstruction to CSF flow out of the ventricles is evident. 

Modality: MRI

The ventricles are enlarged and a very pronounced flow void is present in the aqueduct. CSF flow studies (not shown) demonstrate elevated stroke volume (>150microL). The corpus callosum is elevated and thinned with fenestration of the septum pellucidum. The callosal angle is not increased however, nor are the sylvian fissures widened. 

Case Discussion

The patient went on to have surgery. Although in this clinical context normal pressure hydrocephalus is likely (definitely a communicating hydrocephalus) the lack of reduced callosal angle and lack of widening of sylvian fissures is a little atypical. The patient was nonetheless shunted and improved clinically. 

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Case Information

rID: 39032
Case created: 17th Aug 2015
Last edited: 15th Feb 2016
Inclusion in quiz mode: Included

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