Sacred Heart Senior Living

What is Normal Pressure Hydrocephalus? (NPH)

A friend of mine, whose father had been diagnosed with Parkinson's disease after a rather sudden onset of symptoms had been receiving treatment for Parkinson's related dementia has now been diagnosed with NPH.

Not many people have heard of or understand what NPH is. If it is caught early, it is possible to minimize damage that can be done. It is considered a "reversible" form of dementia but the longer someone lives with this condition, the longer recovery may take and do to the pressure on the brain, the patient may not bounce back to the cognitive and physical abilities that were once the norm for them. First, let me explain what it is!

What is Normal Pressure Hydrocephalus?
It is an abnormal buildup of cerebrospinal fluid (CSF) in the brain's ventricles, or cavities. It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way. This causes the ventricles to enlarge, putting pressure on the brain. It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop NPH even when none of these factors are present. In these cases the cause of the disorder is unknown.

Symptoms of NPH may include a relatively sudden onset of symptoms or a slower progressive cognitive impairment, problems with walking(falls/movement disorder) and become incontinent of bladder. If these symptoms come on realitively suddenly, the person needs to get to the ER immediately. Because these symptoms are similar to those of other disorders such as Alzheimer's disease, Parkinson's disease, the disorder is often misdiagnosed. Many cases go unrecognized and are never properly treated. Doctors may use a variety of tests, including brain scans (CT and/or MRI), a spinal tap or lumbar catheter, intracranial pressure monitoring, and neuropsychological tests, to help them diagnose NPH and rule out other conditions.

Is there any treatment?
Treatment for NPH involves surgical placement of a shunt in the brain to drain excess CSF into the abdomen where it can be absorbed as part of the normal circulatory process. This allows the brain ventricles to return to their normal size. Regular follow-up care by a physician is important in order to identify subtle changes that might indicate problems with the shunt.

What is the prognosis?
The symptoms of NPH usually get worse over time if the condition is not treated, although some people may experience temporary improvements. While the success of treatment with shunts varies from person to person, some people recover almost completely after treatment and have a good quality of life. Early diagnosis and treatment improves the chance of a good recovery. Without treatment, there is little chance of recovery.