Differential Diagnosis for 66 year old male with CT showing dilation of the posterior horns of the lateral ventricles and third ventricle
- Single most likely diagnosis
- Normal Pressure Hydrocephalus (NPH): This condition is characterized by the enlargement of the cerebral ventricles, often with a pattern similar to what is described, and can be asymptomatic or present with subtle clinical signs that may not be immediately apparent, especially in the early stages.
- Other Likely diagnoses
- Age-related atrophy: As people age, there is a natural atrophy of brain tissue that can lead to a relative enlargement of the ventricles, which might be more pronounced in certain areas like the posterior horns of the lateral ventricles.
- Chronic idiopathic hydrocephalus: Similar to NPH but without the classic triad of gait disturbance, dementia, and urinary incontinence, or with a less clear clinical presentation.
- Do Not Miss diagnoses
- Aqueductal stenosis: A congenital or acquired narrowing of the aqueduct of Sylvius, which could lead to an obstruction of cerebrospinal fluid (CSF) flow, resulting in the dilation of the lateral and third ventricles. Although less common in adults, it's crucial not to miss due to potential for treatment.
- Colloid cyst of the third ventricle: A benign tumor that can obstruct CSF flow at the level of the third ventricle, leading to hydrocephalus. It's relatively rare but can be life-threatening if it causes acute obstruction.
- Rare diagnoses
- Dandy-Walker malformation: A congenital disorder characterized by hypoplasia of the cerebellar vermis and cystic dilation of the fourth ventricle, which might also affect the size and shape of other ventricles. It's typically diagnosed in infancy or childhood but could potentially present later in life with less typical symptoms.
- Neurodegenerative diseases with hydrocephalus (e.g., hydrocephalic form of Huntington's disease): Certain neurodegenerative diseases can have a component of hydrocephalus, which might present with ventricular dilation similar to what is described. These are rare and would typically be accompanied by other significant clinical findings.