Corpus Callosum Hyperintensity in Normal Pressure Hydrocephalus After Ventriculoperitoneal Shunt

A 73-year-old man presented with a 10-year history of gait instability, cognitive impairment, and urinary incontinence. Brain MRI (figure, A–C) and a positive response to tap test suggested a clinical diagnosis of normal pressure hydrocephalus (NPH). Venticulo-peritoneal shunt improved his symptoms without complications but was associated with changes in corpus callosum and narrow ventricle, possibly suggesting overdrainage (figure, D–F). Callosal stretch injury is poorly studied in NPH and rarely reported in postmortem NPH pathology.1 Although detected in patients treated for obstructive hydrocephalus,2 postshunt callosal hyperintensity is a poorly understood and little-known radiologic sign.

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