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Communicating Hydrocephalus: Normal Pressure Hydrocephalus

A 75 year old woman presented with gait difficulty, urinary incontinence and difficulty with concentration.

Show the Enlarged Ventricles                                 Show the Transependymal Edema

Axial CT scans: Hydrocephalus is recognized as enlarged ventricles out of proportion to the amount of cerebral atrophy (i.e., hydrocephalus ex vacuo). Communicating hydrocephalus occurs then the ventricular system is in continuity with the subaranchoid space and all the ventricles are enlarged, including the fourth ventricle. Note in left image, the fourth ventricle is enlarged as well. This patient had normal pressure hydrocephalus, a condition that can be confused with primary dementing disorders.

Revised 04/21/06.
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