What imaging technique is most useful in confirming normal pressure hydrocephalus?

• A. MRI of the brain
• B. CT scan of the brain
• C. X-ray of the skull
• D. Ultrasound of the head

Answer: (B)

The most useful imaging technique for confirming normal pressure hydrocephalus is an MRI of the brain. MRI is highly effective in visualizing the brain's structures and can identify the classic features associated with normal pressure hydrocephalus, which include ventricular enlargement in the absence of significant cortical atrophy and characteristic findings such as periventricular edema.

While CT scans can also show ventricular enlargement and are sometimes used in practice, MRI offers greater sensitivity and detail, particularly for detecting associated changes in brain tissue. MRI can visualize subtle changes and differentiates normal pressure hydrocephalus from other conditions that could present similarly.

Other imaging options, such as X-ray of the skull and ultrasound of the head, are not appropriate for confirming this condition. An X-ray would not provide detailed information about the intracranial structures and could miss critical findings. Ultrasound is typically limited to neonates and provides less structural detail compared to MRI or CT. Thus, MRI is the best choice for assessing and confirming normal pressure hydrocephalus.