A 72-year-old man presents with progressive difficulty walking, urinary incontinence, and memory impairment over the past 6 months. His family describes his gait as "shuffling" and "magnetic." Neurological examination reveals a wide-based, unsteady gait and mild cognitive deficits. Brain MRI shows ventriculomegaly disproportionate to sulcal atrophy. Which of the following is the most appropriate next step in management?
✓ Correct Answer: Option A
The triad of gait disturbance, urinary incontinence, and cognitive impairment, along with ventriculomegaly, is classic for Normal Pressure Hydrocephalus (NPH). A diagnostic and often therapeutic lumbar puncture with CSF removal is the next step to assess for symptom improvement.