Volume 12 Supplement 1

Abstracts from Hydrocephalus 2015

Open Access

The NPH radscale; a new radiological scale for evaluation of suspected normal pressure hydrocephalus

  • Karin Kockum1Email author,
  • Elna-Marie Larsson2,
  • Otto Lilja-Lund1,
  • Michelle Rosell1,
  • Lars Söderström3,
  • Johan Virhammar4 and
  • Katarina Laurell1
Fluids and Barriers of the CNS201512(Suppl 1):P27


Published: 18 September 2015


Imaging of the brain with computerized tomography (CT) or magnetic resonance imaging (MRI) is crucial to support the diagnosis of normal pressure hydrocephalus (NPH). The aim of this study was to construct a radiological scale, composed of morphological signs of NPH, and compare with an existing scale for clinical NPH symptoms developed by Hellström et al[1].


In a prospective population-based study of the prevalence of NPH, 91 individuals (43 males), mean age 74 years (range 66-92 years), underwent CT of the brain and neurological examination with assessment of clinical symptoms. A radiological scale consisting of eight radiological parameters was developed and correlated with the clinical NPH scale score to yield a reliable diagnostic tool. Two independent radiologists, blinded to clinical data, visually assessed and performed all measurements of the parameters Evans index >0.3, callosal angle <90°, narrow high convexity sulci, focally dilated sulci, dilated Sylvian fissures, focal bulging of ventricular roof, dilated temporal horns, and periventricular hyperintensities. After conversion into points, the parameters were summarized yielding a score ranging from 0 to 10 points where higher scores indicates more severe radiological changes.


Mean clinical NPH score was 83 (min 30, max 100, SD=17). Mean NPH radscale was 2 (min 0, max 10, SD=2). There was a significant correlation (rs=0.5, p<0.0001) between the new NPH radscale and clinical NPH symptoms as assessed by the NPH symptom scale.


The new NPH radscale seems to be a promising tool for diagnosing NPH.

Authors’ Affiliations

Department of Pharmacology and Clinical Neuroscience, Unit of Research, Education and Development
Department of Surgical Sciences, Radiology, Uppsala University
Unit of Research, Education and Development, östersund Hospital, Region Jämtland Härjedalen
Dept of Neuroscience, Neurology, Uppsala University Hospital


  1. Hellstrom P, et al: A new scale for assessment of severity and outcome in iNPH. Acta Neurol Scand. 2012, 126 (4): 229-37. 10.1111/j.1600-0404.2012.01677.x.View ArticlePubMedGoogle Scholar


© Kockum et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.