Colpocephaly is a rare neurodevelopmental disorder characterized by disproportionate dilatation of the occipital horns of the lateral ventricles due to impaired neuronal migration. Fewer than 30 adult cases have been reported in the literature. We describe a 60-year-old male who presented with panic attacks and headache, in whom neuroimaging revealed posterior cortical atrophy, hypoplasia of the septum pellucidum, parietal white matter disease, and features consistent with colpocephaly. While this condition typically presents in childhood with seizures, developmental delay, and cognitive impairment, adults are often asymptomatic and rarely present with nonspecific symptoms such as headache or dizziness. Diagnosis is radiologic, and management is limited to symptomatic treatment, as no definitive therapy exists. This case underscores the importance of recognizing colpocephaly in adults and differentiating it from normal pressure hydrocephalus, which carries very different clinical and therapeutic implications.