Normal pressure hydrocephalus

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Frequent falls

Patient Data

Age: 70 years
Gender: Female
mri

At least moderate hydrocephalus is noted, most prominently involving the lateral and third ventricles. The sulci are relatively effaced. Prominent CSF flow is demonstrated through the cerebral aqueduct, with elevated aqueduct stroke volume of 160 microL. Note is however made of some relative narrowing of the proximal aqueduct on the CISS sequence, of dubious significance in the context of the high aqueductal stroke volume.

Scattered white matter FLAIR hyperintensities in keeping with small vessel ischemic change.

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