What is normal pressure hydrocephalus?
Normal pressure hydrocephalus is a type of communicating hydrocephalus characterized by ventriculomegaly with normal CSF pressure, altered CSF dynamics.
What is imaging finding of normal pressure hydrocephalus
– Enlarged lateral ventricles and 3rd ventricle are seen on imaging, 4th ventricle is relatively normal
– Disproportional enlargement of ventricles to cortical sulcal enlargement
– Periventricular high signal transependymal CSF flow
– 18F-FDG PET shows decreased regional cerebral metabolism
What is top differential diagnosis of normal pressure hydrocephalus?
NPH should be differentiated normal aging brain with diffuse brain atrophy
; cerebral sulci and cisterns are relatively not dilated in NPH
Note that cerebral sulci and cisterns are not enlarged.
What is treatment of normal pressure hydrocephalus?
Treatment
– CSF shunt
– Shunt types ; Ventriculopertonela (VP), Ventriculoatria (VA), Ventriculopleural (VPL), Lumboperitoneal (LP)
– Complications
: Secondary (iatrogenic) intracranial hypotension → treat with Epidural blood patch
: Infection ; ventriculitis, brain abscess… etc.
