Neuroimaging: normal pressure hydrocephalus: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: normal pressure hydrocephalus

Sample item

An elderly man has gait disturbance, urinary incontinence and cognitive decline. MRI shows ventricular enlargement out of proportion to sulcal widening, and a flow void in the aqueduct. Which condition is suggested?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Normal pressure hydrocephalus

NPH presents with the triad of gait apraxia, incontinence and dementia, with disproportionate ventriculomegaly, narrow high-convexity sulci and a hyperdynamic aqueductal flow void. Large volume lumbar puncture predicts response to shunting. Alzheimer disease shows ventricular enlargement proportional to atrophy.

Option by option

  • A. Parkinson disease

    Parkinson disease has no specific ventricular pattern.

  • B. Normal pressure hydrocephalus (correct)

    Correct. Disproportionate ventriculomegaly with the clinical triad suggests NPH.

  • C. Alzheimer disease

    Alzheimer disease shows hippocampal atrophy with proportionate ventricular enlargement.

  • D. Vascular dementia only

    Vascular dementia shows white matter lesions and infarcts.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Normal pressure hydrocephalus. NPH presents with the triad of gait apraxia, incontinence and dementia, with disproportionate ventriculomegaly, narrow high-convexity sulci and a hyperdynamic aqueductal flow void.

Why is "Parkinson disease" not the answer?

Parkinson disease has no specific ventricular pattern.

Why is "Alzheimer disease" not the answer?

Alzheimer disease shows hippocampal atrophy with proportionate ventricular enlargement.

Why is "Vascular dementia only" not the answer?

Vascular dementia shows white matter lesions and infarcts.

What concept does this question test?

It tests Neuroimaging: normal pressure hydrocephalus in Radiology. Large volume lumbar puncture predicts response to shunting. Alzheimer disease shows ventricular enlargement proportional to atrophy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: normal pressure hydrocephalus?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.