Normal pressure hydrocephalus
Diagnosis certain
Updates to Study Attributes
Findings
was changed:
Lateral ventricles are enlarged with an acute callosal angle and sulcal crowding at the vertex especially compared to large Sylvian fissures. Cerebral aqueduct is large in calibre with hyperdynamic flow.
On CSF flow studies the average stroke volume = 282 microlitres, which is considerably elevated.
Periventricular and scattered white matter T2/FLAIR hyperintensities, and patchy signal in the pons, suggestive of chronic small vessel ischaemia.
Incidental punctate regions of abnormal diffusion restriction within the right frontal and temporal cortex, left occipital cortex, as well as the left anterior limb of the internal capsule, are inkepingin keeping with small embolic infarcts. No focal region of abnormal susceptibility.
Conclusion:
- Morphologic features are consistent with normal pressure hydrocephalus, in this appropriate clinical context.
- Multifocal punctate regions of abnormal diffusion restriction suggest tiny infarcts, presumably of central embolic origin given involvement of multiple territories.
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