Reason: question of hydrocephalus vs. NPH History: ataxia, vertigo, lightheadedness There is no evidence of intracranial hemorrhage, mass, or acute infarct. There are a few scattered periventricular T2 hyperintensities which are nonspecific. The lateral ventricles are mildly enlarged. The third is slightly prominent. The fourth ventricle appears small with apparent slight crowding of the posterior fossa. The cerebral aqueduct is not optimally visualized. There is no midline shift or herniation. The major cerebral flow voids are intact.
1.No acute infarct.2.Lateral ventricles are mildly enlarged and there is mild prominence of the third ventricle, which is nonspecific. However the fourth ventricle does appear small with crowding of the posterior fossa, with suboptimal visualization of the cerebral aqueduct. Given the small fourth ventricle, normal pressure hydrocephalus is felt to be less likely. A CSF flow study may be helpful for further characterization.