Normal pressure hydrocephalus

Case contributed by Dr Bruno Di Muzio

Presentation

Gait disturbance characterised by feet seeming to be attached to the floor ("magnetic gait"). Mild cognitive impairment.

Patient Data

Age: 82-year-old
Gender: Female

MRI Brain

Modality: MRI

Technique: Multiplanar and multisequence images were obtained through the brain, without contrast administration. 

Findings: Multiple T2/FLAIR hyperintensities foci somehow confluent, are present scattered through the subcortical and periventricular white-matter which likely represent chronic small vessel ischaemia prominent in severity for this age. 

Mild brain atrophy, without lobar distribution. The lateral and third ventricles are dilated compared to the sulcal pattern and the corpus callosum is displaced upward. The callosal angle is reduced to values between 50-80 degrees. 

There is an extra-axial calcification in the left parietal region, non-specific.

The remainder exam is unremarkable. 

Conclusion: The findings are in keeping with normal pressure hydrocephalus. 

Case Discussion

Normal pressure hydrocephalus is still a quite controversial condition, but in cases like this one, where there are clinical symptoms and signs associated with typical imaging features, the diagnosis can be made with security and treatment may be proposed depending on the other prognostic factors. 

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Case Information

rID: 41180
Case created: 19th Nov 2015
Last edited: 19th Nov 2015
Inclusion in quiz mode: Included

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