Abstract
Idiopathic normal pressure hydrocephalus (INPH) is characterized by the clinical triad of gait and cognitive dysfunction and urinary incontinence. Ventriculoperitoneal (VP) shunting is often required for treatment. Review of literature shows few case reports discussing benign magnetic resonance imaging (MRI) T2 hyperintense changes in the corpus callosum of NPH patients after shunting due to mechanical compression of the middle and posterior regions of the body against falx cerebri leading to ischemic demyelination. These changes can be a delayed phenomenon and may interfere with clinical evaluation and may lead to unnecessary procedures and investigations. We present a patient with NPH who was admitted to the neurocritical care unit in coma with quetiapine and trazodone overdose. Diffuse changes in the body of the corpus callosum were seen on MRI suspicious for acute vasogenic edema due to drug overdose. However, it was later determined to be due to the VP shunting for the NPH. We report this case to raise the awareness of neuroimaging changes in patients with NPH who have VP shunting.
Copyright
Association for Helping Neurosurgical Sick People. This is an open
access article published by Thieme under the terms of the Creative
Commons Attribution-Non Derivative-Non Commercial License, permitting
copying and reproduction so long as the original work is given
appropriate credit.
Contents may not be used for commercial purposes, or
adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/
)
This is an open-access article distributed under the terms of the
Creative Commons Attribution-Non Commercial-No Derivatives License, which
permits unrestricted reproduction and distribution, for non-commercial
purposes only; and use and reproduction, but not distribution, of
adapted material for non-commercial purposes only, provided the original
work is properly cited.
