Acta Neurochirurgica

, Volume 159, Issue 6, pp 1005–1011

Oropharyngeal dysphagia in secondary normal pressure hydrocephalus due to corticobulbar tract compression: cases series and review of literature

  • Kwang Wook Jo
  • Youngkook Kim
  • Geun-Young Park
  • Ik Seong Park
  • Yongjun Jang
  • Sohn Dong Gyun
  • Sun Im
Case Report - Functional


The association and mechanism involved in swallowing disturbance and normal pressure hydrocephalus (NPH) needs to be established. We report a case report where a patient who showed progressive swallowing dysfunction was diagnosed with secondary NPH. Tractography analysis showed corticobulbar tract compression by ventricular dilation. Drainage operation led to the recovery of tract volume with an improvement of swallowing function. We also report ten case series in which secondary NPH was associated with a swallowing disturbance. In these cases, dysphagia also showed improvement after shunt operation. We review the literature regarding the corticobulbar tract and its association with swallowing disturbance and the possible underlying pathophysiological mechanism in secondary NPH. This report highlights that swallowing disturbance may manifest in those with secondary NPH due to corticobulbar tract involvement. Our findings suggest that involvement of the corticobulbar tract may be a possible cause of dysphagia in secondary NPH that may be reversible after shunt operation.


Hydrocephalus Diffusion tensor imaging Deglutition disorders Corticobulbar tract 



Normal pressure hydrocephalus


Corticobulbar tract


Diffusion tensor imaging


Functional Oral Intake Scale


Modified Rankin Scale


Videofluoroscopic Swallowing Study


Videofluoroscopic Dysphagia Scale


Modified Barium Swallow Impairment Profile©


Computed tomography


Regions of interest


Cerebrospinal fluid


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Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  1. 1.Department of Neurosurgery, Bucheon St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaBucheon-siSouth Korea
  2. 2.Department of Rehabilitation MedicineRHIIN HospitalPoeunDeroSouth Korea
  3. 3.Department of Rehabilitation Medicine, Bucheon St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaBucheon-siSouth Korea

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