iNPH Radscale

1

Evans Index

Ratio of maximum width of frontal horns to maximal internal skull diameter on axial plane.

Radiopaedia

Interactive Measurement Assistant:

Frontal Horn Width (A):

mm

Internal Skull Width (B):

mm

Calculated Ratio: --

≤ 0.25

Normal ventricular size

0 pt

0.26 – 0.30

Borderline ventriculomegaly

1 pt

> 0.30

Definite ventriculomegaly

2 pts

2

Narrow Parietal High-Convexity & Medial Parafalcine Sulci

Assessed in the most superior axial and coronal planes (DESH high-convexity crowding).

Normal

No narrow high-convexity sulci

0 pt

Parafalcine

Narrowing along medial parafalcine region

1 pt

Vertex

Narrowing extending to high convexity vertex

2 pts

3

Sylvian Fissures

Dilation of Sylvian fissures compared to adjacent high convexity sulci on coronal plane.

Normal

Proportional to surrounding sulci

0 pt

Enlarged

Disproportionately dilated Sylvian fissures

1 pt

4

Focally Enlarged Sulci

Disproportionately enlarged focal cerebral sulci compared to surrounding sulci.

Not Present

No focally expanded sulci

0 pt

Present

One or more focally dilated sulci

1 pt

5

Temporal Horns

Maximum diameter of temporal horns measured in the axial plane.

Interactive Direct Measurement:

Temporal Horn Width:

mm

Status: Select or enter mm

< 4 mm

Normal temporal horns

0 pt

4 – 5.9 mm

Moderately enlarged

1 pt

≥ 6 mm

Markedly dilated

2 pts

6

Callosal Angle

Measured on coronal MRI/CT perpendicular to ACPC line at level of posterior commissure.

Radiopaedia

Interactive Angle Measurement:

Angle in Degrees:

°

Category: > 90° (Normal)

> 90°

Normal wide angle

0 pt

60° – 90°

Moderately acute angle

1 pt

≤ 60°

Sharply acute angle (DESH)

2 pts

7

Periventricular White Matter Change

Periventricular hyperintensities evaluated according to the Fazekas scale.

Radiopaedia

Not Present

Fazekas grade 0 (No PVWM changes)

0 pt

Frontal Horn Caps

Fazekas grade 1 (Pencil-thin caps)

1 pt

Confluent Areas

Fazekas grade 2–3 (Confluent halos)

2 pts