Normal pressure hydrocephalus (NPH) was first described by Hakim and Adams in 1965. At the time NPH was first described, it also took attention with being the first treatable type of dementia. It is now thought to be the reason nearly for the 6% of all dementia cases. NPH has the special triad of the symptoms consisting of gait disturbance, cognitive impairment and urinary dysfunction with accompanying ventricular dilation. NPH is often seen in elderly people and diagnosis in the early stage is difficult because of its insidious progress. Our aim is to present a case, which was first diagnosed with dementia and after 3 years of being followed, with occurrence of new symptoms NPH was defined. A62-year-old, married, farmer, male patient living with his family, who had a family history of Alzheimer’s Disease is our case. He had memory impairments 3 years ago. His brain MRI revealed only cerebral atrophy and he has got the diagnosis “dementia” from neurology outpatient clinic. He was treated with donepezil and memantine. A year ago, when his new complaints like disorganized behaviors, visual hallucinations were started, he applied to psychiatry outpatient clinic of Denizli State Hospital with this new clinic presentation; valproic acid 500 mg/per day, rivastigmine 10 mg/per day and piracetam 1600 mg/per day were added on his treatment. For the last 6 months before coming to our hospital’s outpatient clinic, he had been suffering from new problems such as gait disturbance, urinary incontinence and also self-mutilative behaviors. He was hospitalized in our inpatient psychiatry clinic. His brain MRI provided evidence for cerebral atrophy, ventricular enlargement and hydrocephalus. The patient was consulted from neurosurgery clinics. Neurosurgeons, with the prediagnosis of NPH, his CSF has been drained out with lumbar drainage kit for four days, and there was a significant improvement in his gait and in his disorganized behaviors. Neurosurgeons offered the patient to have the ventro peritoneal shunt operation but his family refused this advice. He was discharged with the diagnosis of “Adams Hakim Syndrome”. Unfortunately his cognitive impairment did not change like the most cases in literature. In the literature, there are case reports, which at the end had the diagnosis of normal pressure hydrocephalus, of patients who applied psychiatry outpatient clinics with psychiatric symptoms accompanying with a diagnosis of dementia for a long time. In dementia presented with atypical symptoms in relatively early ages and in which the cognitive status impairs dramatically, even if there may not yet be all of the three symptoms of NPH in the patient’s clinic presentation, NPH can be one of the possible etiologic factors.