NEJM临床医学影像颅压正常脑积

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ImagesinClinicalMedicineVentriculoperitoneal-ShuntPlacementforNormal-PressureHydrocephalusMahmoudA.AbdelRazek,NagagopalVennaNEnglJMed;:e35DOI:10./NEJMicm

A70-year-oldwomanpresentedtotheneurologyclinicwitha2-yearhistoryofgaitdisturbance,cognitiveimpairment,andurinaryincontinence.ExaminationrevealedaMini–MentalStateExamination(MMSE)scoreof12(onascaleof0to30,withhigherscoresrepresentingbetterperformance)andashort-stepped,narrow-based,nonataxicgait.Thepatientwalked7.6min31seconds(Video1).Magneticresonanceimagingrevealedballooningoftheventricles,withanEvan’sratio(theratioofthewidthofthefrontalhornsofthelateralventricles[45mminthispatient]totheinternaldiameteroftheskull[mm])of0.37(upperlimitofthenormalrange,0.31)(PanelA).Thecallosalangle(PanelB,whitearrow)—theangle(outlinedinwhite)betweenthelateralventriclesmeasuredattheleveloftheposterior







































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