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On 5 Sep 2003 at 22:23, Roberta Innarella wrote: > How is NPH diagnosed and would it be something that neuros would > necessarily be looking for? Roberta It usually begins when a CT scan or MRI of the head (which should be done in all cases of suspected PD) reveals enlarged ventricles. If the patient has a significant part of the "triad" (symptoms necessary to make the diagnosis), a test called a "cisternogram" is done. This consists of doing a spinal puncture and injection of a small amount of radioactive substance into the spinal fluid. Isotope scans are then done at 4 hours, 24 hours, and 48 hours, and the radioactive tracer is followed as it passes through the head and is re-absorbed. The "triad" of NPH is: 1. Dementia 2. Gait disturbance (can be Parkinsonian-like) 3. Urinary incontinence If the above is present and the cisternogram is positive, a shunt is considered. Best, Bob ********************************************** Robert A. Fink, M. D., F.A.C.S., P. C. 2500 Milvia Street Suite 222 Berkeley, California 94704-2636 Telephone: 510-849-2555 FAX: 510-849-2557 WWW: http://www.rafink.com/ mailto:[log in to unmask] "Ex Tristitia Virtus" ********************************************* ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn