Comorbidity of normotensive hydrocephalia and Parkinson’s disease

Abstract

Normotensive hydrocephalus (NTH) is a syndrome characterized by enlarged ventricles of the brain, gait disturbance, cognitive impairment, and incontinence. In the elderly with gait disturbances of unspecified etiology, NTH should always be excluded. It is especially difficult to diagnose NTH in patients with neurodegenerative diseases, primarily with idiopathic Parkinson’s disease (PD), and vice versa, to diagnose PD in patients with NTH. We report on an 80-year-old patient with a five-year history of NTH, manifested by the classic clinical triad of symptoms and the subsequent development of Parkinson’s syndrome 3 years after the debut of NTH. MRI of his brain revealed ventriculomegaly and transcranial sonography did hyperechogenicity of the substantia nigra on the left, with an area of 0.41 cm2, which made it possible to diagnose two comorbid diseases in the patient, namely, normotensive hydrocephalus and Parkinson’s disease.