Abstract
Normal pressure hydrocephalus (NPH) is one of the few treatable causes of dementia by ventriculo-peritoneal shunting. Phase contrast CSF velocity imaging has been shown to be useful for diagnosing shunt reponsiveness, based on the aqueductal CSF stroke volume. It is suggested that idiopathic NPH begins as benign external hydrocephalus in infancy. The arachnoid granulations have decreased resorptive capacity which necessitates outflow of CSF from the ventricles to the subarachnoid space via the extracellular space of the brain. Increasing resistance to this outflow in late adulthood due to deep white matter ischemia leads to progressive ventricular enlargement and symptoms of NPH.
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