Normal pressure hydrocephalus

The classical triad of normal pressure hydrocephalus is 
  • Gait abnormality 
  • Urinary incontinence 
  • Dementia 

However, only a minority of patients present with this triad, and gait abnormality is the commonest finding.  The gait associated with normal pressure hydrocephalus is described as shuffling or broad-based.

It is one of the few reversible causes of dementia.

  • CT/MRI head – looking for ventricular enlargement
  • Large volume lumbar puncture - ? temporary improvement of symptoms 
  • CSF infusion test 

Treatment is by shunting - ventriculoperitoneal, ventriculopleural or ventriculoatrial. 
Around 60% of patients show improvement after shunting. 

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