Normal Pressure Hydrocephalus: A Histologic Study

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Abstract
The clinical histories of patients with the syndrome “normal pressure hydrocephalus” usually reveal an antecedent basis for the impeded absorption of spinal fluid. However, a small proportion of these patients have an insidious onset of this disease for no demonstrable reason. We are reporting such a case with autopsy findings. The morphologic changes were compatible with a significant degree of obstruction to flow of cerebrospinal fluid. Histologically, there was no evidence of recent inflammation or hemorrhage. Although the cause of the meningeal fibrosis, subependymal gliosis, and changes in the arachnoid villae was not clear, these changes could be secondary to an unrecognized previous meningitis. We will have to await the description of more cases before any definite conclusions can be made regarding the etiology of this clinical entity.

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