NPH (Slow onset, progressive)
Clinical presentation
Characterized by gait abnormality, urinary incontinence, and cognitive impairment, with ventriculomegaly.
Diagnosis
Dilated ventricles on MRI, negligible cortical atrophy.
Fluorodopa PET - decreased blood flow to basal ganglia.
DaT Scan - reduced uptake in Striatum .
Patho-mechanism
Increased strain in the periventricular area, and insufficient blood supply to basal ganglia (especially nigrostriatal connections).
Associated features
Parkinsonism, hypokinesia mainly, may be the presenting feature. Shuffling gait is observed.