Anxiety disorder revealing a normal pressure hydrocephalus: case report and CT findings

Abstract

Normal pressure hydrocephalus (NPH) describes a constellation of imaging and clinical findings, in particular, with dilated ventricles on imaging, normal CSF pressures on lumbar puncture, it presents with a clinical triad of gait ataxia, dementia and urinary incontinence.It is considered an idiopathic condition, with the exact pathogenesis still controversial.The incidence of NPH increases with age.We report the case of a 54-year-old man who presented with recent disabling anxiety and otherwise a minimal change in gait and urinary incontinence, with orienting scanographic findings.A dramatic response was observed to lumbar puncture, wich was followed by ventriculoperitoneal shunt placement.The CT features in NPH are highly suggestive, but cannot provide a definitive diagnosis.CT must be followed by MRI, CSF pressure measurement and therapeutic tests.