Normal Pressure Hydrocephalus – An Overview

Normal Pressure Hydrocephalus

Normal Pressure Hydrocephalus (NPH)  is the result of an accumulation of excessive Cerebrospinal Fluid (“brain water”) inside the chambers of the brain.

It is a reversible cause of dementia.

High pressure comes in waves that can be measured by a pressure sensor which is placed inside the spinal canal or brain. As patients age, the pressure elevations come more frequently and severely.

Over the years, this constant battering takes its toll on the blood vessels of the brain, causing poor blood flow and oxygen delivery. The brain tissues take a beating and eventually starts to fail.  It is possible that around 250,000 patients diagnosed with Alzheimer’s Dementia may instead have NPH.  Many patients have both.

There are three classic findings associated with NPH:

  1. Difficulty walking.
  2. Memory loss.
  3. Urinary incontinence.

Diagnosis:

  1. On clinical grounds, history is important.
  2. Spinal fluid removal, decompression of the brain.
  3. Neuroimaging studies.

hydrocephalus ribbon

Treatment

  1. Conservative = Medication.
  2. Less conservative = periodic spinal taps (“Lumbar puncture”)
  3. Definitive treatment = brain shunt (“bypass”)
VP Shunt

Ventriculoperitoneal Shunt

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