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Normal pressure Hydrocephalus

Normal pressure hydrocephalus (NPH) is an abnormal build-up of cerebrospinal fluid (CSF) in the ventricles or cavities of the brain. It occurs when the normal flow of CSF through the brain and spinal cord is somehow blocked. This causes the ventricles to enlarge, putting pressure on the brain. Normal pressure hydrocephalus can occur in people of any age, but it is most common in the elderly. It can be the result of a subarachnoid hemorrhage, head trauma, infection, tumor, or complications from surgery. However, many people develop NPH even if none of these factors are present. In these cases, the cause of the condition is unknown.

Symptoms of NPH include progressive mental decline and dementia, difficulty walking, and decreased bladder control. The person may also have a general slowing of their movements or complain that their feet feel "stuck". Because these symptoms are similar to those of other conditions, such as Alzheimer's disease, Parkinson's disease, and Creutzfeldt-Jakob disease, the condition is often misdiagnosed. Many cases go unrecognized and are never treated properly. Doctors can use a variety of tests, including brain scans (CT and / or MRI), an epidural or lumbar catheter, intracranial pressure monitoring, and neuropsychological tests, to help diagnose NPH and rule out other conditions.


Treatment for NPH involves surgical placement of a shunt in the brain to drain excess CSF from the abdomen, where it can be absorbed as part of the normal circulation process. This allows the brain ventricles to return to their normal size. Regular follow-up care by a physician is important to identify subtle changes that may indicate problems with the shunt.


NPH symptoms usually get worse over time if the condition isn't treated, although some people may experience temporary improvements. While the success of shunt treatment varies from person to person, some people recover almost completely after treatment and have a good quality of life. Early diagnosis and treatment increases the chance of a good recovery. Without treatment, symptoms can worsen and result in death.

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