Normal Pressure Hydrocephalus

A Simple Guide to Normal Pressure Hydrocephalus
---------------------------------------------------------

What is Normal Pressure Hydrocephalus?
--------------------------------------------

Normal Pressure Hydrocephalus(NPH) is an abnormal accumulation of cerebrospinal fluid in the cavities of the brain.

Who is at risk of getting Normal Pressure Hydrocephalus?
-------------------------------------------------------------

Normal Pressure Hydrocephalus occurs in adults of 55 years old and above.

The accumulation of cerebrospinal fluid is gradual leading to enlargement of the cavities in the brain called ventricles.

This in turn stretches the nerve tissues of the brain giving rise to 3 main neurological disturbances in the brain which is characteristic of NPH.

What are the causes of Normal Pressure Hydrocephalus?
------------------------------------------------------------

In most cases the cause is unknown.

In the remaining cases, the secondary causes can be found:

1. Brain infection can cause damage to brain tissues and the resulting cell damage can increase fluid in the brain

2. Stroke may damage brain cells resulting in damaged brain tissues and increase fluid in the brain

3. Trauma and head injury may damage brain cells similar to above

4. Brain tumors are another cause of increased fluid in the brain


What are the Symptoms of Normal Pressure Hydrocephalus?
----------------------------------------------------------------

Onset is slow and gradual but typically the following symptoms are present:

Gait disturbance
-----------------

Difficulty in walking or balancing

Cognitive impairment
---------------------------

mild dementia

Urinary Incontinence
---------------------

Problems with bladder control and hence incontinence

How is the diagnosis of Normal Pressure Hydrocephalus confirmed?
------------------------------------------------------------------------

1.History of the above 3 symptoms

2.Physical examination shows the neurological deficits:
difficulty in walking

mild dementia

urinary incontinence

3.MRI of brain shows the presence of enlarged ventricles in the brain

What is the Treatment of Normal Pressure Hydrocephalus?
-------------------------------------------------------------------

NPH cannot be cured but its symptoms can be controlled.

Treatment is by surgery using a shunt to divert the excessive fluid in the brain to the peritoneal cavity.

What are the complications of Normal Pressure Hydrocephalus?
-------------------------------------------------------------------

1. Dementia

2. Disabilty

3. Disturbed urinary and bowel function.

What is the prognosis of Normal Pressure Hydrocephalus?
------------------------------------------------------------------------

With early diagnosis and treatment, symptoms can be partially or fully reversed leading to resumption of a normal life.

With the use of the shunt, symptoms may disappear within days or at most a few months.

There is dramatic improvement in the first week in mild cases.

Some adjustments of the valve are often needed before the correct setting is obtained for the individual.