Normal pressure hydrocephalus typically presents with a clinical triad of progressively worsening symptoms, including gait disturbance, urinary incontinence, and cognitive deficits. Occasionally, it may also manifest with significant psychiatric symptoms, which can delay early diagnosis and treatment. We present a rare case of chronic hydrocephalus in a 54-year-old patient who initially presented with symptoms of mania, which led to a delay in diagnosis and treatment. Our case highlights the importance of considering organic causes for psychiatric symptoms, especially in older patients. Early diagnosis and treatment of conditions such as hydrocephalus can prevent delays and improve patient outcomes.
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