Normal pressure hydrocephalus and hypertensive cerebrovascular disease

This report compares the clinical and post mortem findings in a case of normal pressure hydrocephalus (NPH) syndrome occurring in association with hypertensive cerebrovascular disease, with the only two such previously reported autopsied cases. The presence of hypertension and focal neurological findings in a patient with otherwise classic clinical and radiologic features of NPH syndrome should alert one to the possibility of hypertensive cerebrovascular disease as the cause of the syndrome. Transient improvement occurred following shunting in two, and none in the third case. All died within three years of illness. It appears shunting is not of significant benefit in these patients.