Normal Pressure Hydrocephalus (NPH) is a neurodegenerative condition in which a buildup of cerebrospinal fluid in the skull puts pressure on the brain. When too much fluid accumulates because the body can’t reabsorb or circulate it correctly, the brain starts to compress. If the brain is compressed for too long, permanent damage can occur.
Who is at risk for NPH?
NPH is a rare condition that occurs most often in people over age 65. Less than 3% of the population is affected. Men and women are affected equally. As people age, their risk factor for developing NPH increases. Because symptoms of NPH are similar to Alzheimer’s Disease, Parkinson’s disease, and other neurodegenerative disorders, people may initially be misdiagnosed. Early diagnosis is key to preventing permanent damage and destruction of brain tissue. When treated early, symptoms may be reversed.
Three Main Symptoms of NPH
- Walking problems – Includes trouble taking steps; difficulty lifting the feet off the floor; trouble making turns; shuffling; feeling off balance. May be prone to falling. May need to use a cane or walker to remain steady.
- Cognitive problems – Includes trouble with thinking skills; memory issues; forgetting how to do routine tasks; disorganization; loss of focus or concentration; loss of interest in activities; emotional changes.
- Bladder control problems – Urge to urinate more frequently; urinary incontinence.
Not all people will exhibit all of the above symptoms. The disease is progressive, so symptoms will get worse over time.
Diagnosis
A physical and neurological exam is necessary. The physician will assess the patient’s walking ability and discuss other symptoms. Answering simple questions and performing simple tasks will help the doctor assess mental sharpness. Imaging tests, such as an MRI or CT scan of the brain, allow the physician to look for changes in the brain that would indicate Normal Pressure Hydrocephalus.
Additional tests can show whether removing some of the cerebrospinal fluid will help relieve symptoms. A spinal tap and a lumbar drain trial can help determine whether the patient will benefit from surgery.
Treatment
There are no medications that will treat NPH. Standard surgical treatment involves placing a shunt in the ventricles of the brain with a drain to the abdomen. This allows excess fluid that is compressing the brain to drain into the abdomen, where it will be absorbed. The symptoms should improve fairly quickly. Early diagnosis and treatment are most successful.
Atlanta Brain and Spine Care
Atlanta Brain and Spine Care is Atlanta’s leading neurosurgical practice with four convenient metro Atlanta locations. Contact us to schedule an appointment with a Board Certified specialist.
