Normal Pressure Hydrocephalus

Harp Bedi
70 year Brain in Two Different Patients

“Normal” Involution (a) Normal Pressure Hydrocephalus (b)

The 2 CT scans show 70 year old brains in two different patients. The patient on the left (a), reveals normal involution of the brain characterized by deepening of the sulci and prominence of the gyri together with a prominent ventricular system. Contrast this brain with the CT scan of the 22 year old above where the sulci and gyri are barely distinguished and the ventricles are slit like. The second patient (b) has a condition called normal pressure hydrocephalus (NPH). In addition to having “normal” involution, the patient also has dilated ventricles more than one would expect for the degree of involution. This is an abnormal finding.

CTscan Courtesy Ashley Davidoff MD copyright 2010 72179c01

These findings are almost classic for normal pressure hydrocephalus.
1) disproportionately enlarged ventricles
2) transependymal edema
3) large sylvian fissures
4) crowding of sulci at the vertex
5) acute callosal angle