Normal pressure hydrocephalus NPH | AIPGMEE Preparations

False about normal pressure hydrocephalus NPH. ? 
A. Commonly presents with papilledema with no focal signs 
B. Ischaracterised by the early onset of urinary incontinence 
C. Characteristically presents with dementia and gait disturbance 
D. May be improved by ventricular shunting

Ans. A. Commonly presents with papilloedema with no focal signs

The classic clinical triad of NPH is dementia with early urinary incontinence and gait disturbance. Patients with NPH may not have these features but the CT scan appearance is often helpful since hydrocephalus is present with an enlarged fourth ventricle but normal or compressed cortical sulci i.e. the pattern of communicating hydrocephalus. . Many patients improve with ventricular shunting though prior CSF flow studies may be necessary to identify patients most likely to improve. If hydrocephalus is present with a normal sized fourth ventricle then the diagnosis is likely to be aqueduct stenosis or other obstructive lesion between the fourth and third ventricle. Papilledema is not a feature of NPH,