Treatment of normal pressure hydrocephalus resolves dorsal midbrain syndrome

  • Joshua A. Smith
  • Fahad J. LaghariEmail author
  • Sandra M. Pinzon
Letter to the Editor

Dear Editors,

We present a unique case of a patient presenting with the signs and symptoms of normal pressure hydrocephalus (NPH) and dorsal midbrain syndrome (DMS), and in whom treatment of former led to the improvement of both. DMS has often been described in the presence of increased intracranial pressure and hydrocephalus; however, according to our knowledge, this is the first report that describes a relationship between NPH and DMS.

A patient in his seventies was admitted to the hospital under the medicine service for pneumonia, sepsis, and falls. The CT scan of the head showed dilated ventricles out of proportion to sulcal size, concerning for NPH (Fig.  1). Neurology was consulted for confusion, falls, and abnormal CT scan of the head. The patient had been started on memantine by a primary care physician for almost a year. A formal inpatient mental status test was not performed as the patient’s confusion may have been exaggerated by sepsis, and the records from PCP were...


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Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Fondazione Società Italiana di Neurologia 2019

Authors and Affiliations

  1. 1.Department of NeurologyUniversity of Pittsburgh Medical Center HamotErieUSA

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