CT / MRI in NPH
CT is inferior.
Periventricular white matter change.
Mri is the best modality. Further support can be obtained from CSF flow studies.
? Evans index > 0.3
? Acute changes in Calosal angle
? Widened Temporal horn of the lateral ventricle > 6 mm
Upward bowing of the corpus callosum
Dilated sylvian fisher
Tight high convexity
Posterior cingulate sulcal narrowing then the interior
Dilation of the transport sulci
Predicting the prognosis with VP shunt :
✅ duration lesson six months
✅ temporary relief of symptoms with the spinal tap removing about 40 ml and / or CSF drain
✅ presence of aqueduct flow void in T2 MRI imaging
⁉️Gait disturbances predates dementia
✅ none or absence of CVAs