E-Pearl of the Week: Head Size in Normal Pressure Hydrocephalus

July 18, 2012


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July 18, 2012

Head Size in Normal Pressure Hydrocephalus

Idiopathic normal pressure hydrocephalus (iNPH) is characterized by enlarged ventricular size, often increased cerebrospinal fluid outflow resistance and normal intracranial pressure. Ten to twenty percent of patients with iNPH –across both genders - have a head circumferences above the 98th percentile compared to normal controls. Consequently, while the mechanism producing NPH in most patients is unknown, it has been suggested that a proportion of patients with iNPH may have congenital hydrocephalus which decompensates and becomes symptomatic in later adult life. It is not known whether head size predicts treatment response in NPH, and the selection of appropriate candidates for invasive shunt procedures remains challenging.
Read more about NPH and the effects of CSF drainage on ventricular size in NPH in this week’s issue of Neurology.


  1. Krefft TA, Graff-Radford NR, Lucas JA, Mortimer JA. Normal Pressure Hydrocephalus and Large Head Size. Alzheimer Dis Assoc Disord 2004; 18: 35-37.
  2. Lenfeldt N, Hansson W, Larsson A, Birgander R, Eklund A, Malm J. Three-day CSF drainage barely reduces ventricular size in normal pressure hydrocephalus. Neurology 2012; 79: 237-242.

Submitted by: Jennifer E. Fugate, DO
Disclosures: Dr. Fugate serves on the editorial team for the Neurology Resident and Fellow Section.

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