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Normal pressure hydrocephalus — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Normal pressure hydrocephalusUSMLE Step 3

A 76-year-old man has 8 months of gait instability, urinary urgency, and cognitive slowing. Gait is broad-based and magnetic. MRI shows ventriculomegaly out of proportion to cortical atrophy. Which of the following is the most likely diagnosis?

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Correct answer: C — Normal pressure hydrocephalus

Gait disturbance, urinary symptoms, cognitive decline, and ventriculomegaly suggest normal pressure hydrocephalus.

Reference: American Academy of Neurology NPH guidance