Presentation
Dementia with gait disturbances.
Patient Data













The MRI sequences demonstrate:
-
dilatation of the third and lateral ventricles with
upward bowing of the corpus callosum
increased Evans index (0.36)
acute callosal angle (52°)
-
disproportionate enlargement of the subarachnoid space with
enlarged Sylvian fissures
narrow sulci and subarachnoid spaces at the vertex and parafalcine region
patchy FLAIR and T2 hyperintensities periventricular the white matter, subcortical region and centra semiovale suggestive chronic small vessel ischaemic change.



Annotated images:
Evans index = 0.36
callosal angle = 53°
Case Discussion
The clinical presentation and the MRI features are most consistent with a normal pressure hydrocephalus.