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.
Investigations:
- 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.
