An 83 years old man presented with progressive walking difficulty for 1 year with recurrent falls, progressive slowing of verbal response and urinary incontinence. Physical examination showed apraxia of gait but there was no evidence of parkinsonism. CT brain of this patient showed dilated ventricles. Lumbar puncture was performed revealing an opening pressure of 10 cm H2O with otherwise normal CSF examinations. A diagnosis of normal pressure hydrocephalus was made and 30ml of CSF was drained. Post-lumbar puncture showed much improvement in gait. Mini-mental state examination showed an improvement from 19 to 24 (total score of 30). The Neurosurgical colleagues were consulted. The patient was offered a ventriculo-peritoneal shunt operation which was performed uneventfully.
Normal Pressure Hydrocephalus
