**Core Concept**
Normal Pressure Hydrocephalus (NPH) is a clinical syndrome characterized by the triad of gait disturbance, dementia, and urinary incontinence, typically occurring in elderly individuals. The pathophysiology involves an accumulation of cerebrospinal fluid (CSF) in the brain's ventricles, leading to increased intracranial pressure and subsequent damage to surrounding brain tissue.
**Why the Correct Answer is Right**
The classic triad of NPH is due to the increased CSF pressure causing damage to the frontal lobes, basal ganglia, and cerebral peduncles. This results in the characteristic gait disturbance, cognitive decline, and urinary incontinence. The frontal lobe damage is responsible for the gait disturbance, which often manifests as a magnetic gait or a gait disorder characterized by a wide-based, shuffling gait.
**Why Each Wrong Option is Incorrect**
* **Option A:** Gait disturbance is indeed a characteristic of NPH, making this option incorrect.
* **Option B:** Dementia is a key feature of NPH, so this option is also incorrect.
* **Option C:** Urinary incontinence is another hallmark of the condition, thus making this option incorrect as well.
**Clinical Pearl / High-Yield Fact**
A key clinical correlation to remember is that NPH often presents with a "normal" CSF pressure on lumbar puncture, despite the presence of increased intracranial pressure. This is because the pressure may be transmitted through the ventricular system, making the lumbar pressure appear normal.
**Correct Answer: A.**
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