Learn About Normal Pressure Hydrocephalus

What is the definition of Normal Pressure Hydrocephalus?

Hydrocephalus is a buildup of spinal fluid inside the fluid chambers of the brain. Hydrocephalus means "water on the brain."

Normal pressure hydrocephalus (NPH) is a rise in the amount of cerebrospinal fluid (CSF) in the brain that affects brain function. However, the pressure of the fluid is usually normal.

What are the alternative names for Normal Pressure Hydrocephalus?

Hydrocephalus - occult; Hydrocephalus - idiopathic; Hydrocephalus - adult; Hydrocephalus - communicating; Dementia - hydrocephalus; NPH

What are the causes of Normal Pressure Hydrocephalus?

There is no known cause for NPH. But the chance of developing NPH is high in someone who previously had any of the following:

  • Bleeding from a blood vessel or aneurysm in the brain (subarachnoid hemorrhage)
  • Certain head injuries
  • Meningitis or similar infections
  • Surgery on the brain (craniotomy)

As CSF builds up in the brain, the fluid-filled chambers (ventricles) of the brain swell. This causes pressure on brain tissue. This can damage or destroy parts of the brain.

What are the symptoms of Normal Pressure Hydrocephalus?

Symptoms of NPH often begin slowly. There are three main symptoms of NPH:

  • Changes in the way a person walks: difficulty when beginning to walk (gait apraxia), feeling as if your feet are stuck to the ground (magnetic gait)
  • Slowing of mental function: forgetfulness, difficulty paying attention, apathy or no mood
  • Problems controlling urine (urinary incontinence), and sometimes controlling stools (bowel incontinence)

Diagnosis of NPH can be made if any of the above symptoms occur and NPH is suspected and testing is done.

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What are the current treatments for Normal Pressure Hydrocephalus?

Treatment for NPH usually requires surgery to place a tube called a shunt that routes the excess CSF out of the brain ventricles and into the abdomen. This is called a ventriculoperitoneal shunt.

Who are the top Normal Pressure Hydrocephalus Local Doctors?
2600 Tuscarawas St W, Suite 540, 
Canton, OH 
 1.3 mi

Jean-claude Tabet is a Neurosurgery provider in Canton, Ohio. Dr. Tabet and is rated as an Advanced provider by MediFind in the treatment of Normal Pressure Hydrocephalus. His top areas of expertise are Hydrocephalus, Cerebellum Agenesis Hydrocephaly, Spinal Stenosis, Microdiscectomy, and Cervical Disc Surgery.

Neurosurgery
Neurosurgery

Ohio Specialty Physicians Corporation

2600 Tuscarawas St W, Suite 440, 
Canton, OH 
 1.3 mi
Accepting New Patients

Rishi Goel is a Neurosurgery provider in Canton, Ohio. Dr. Goel and is rated as an Advanced provider by MediFind in the treatment of Normal Pressure Hydrocephalus. His top areas of expertise are Subdural Hematoma, Chronic Subdural Hematoma, Delirium, Laminectomy, and Vertebroplasty. Dr. Goel is currently accepting new patients.

 
 
 
 
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Neurosurgery
Neurosurgery
2600 Tuscarawas St W, Ste. 520, 
Canton, OH 
 1.3 mi
Accepting New Patients

Mark Weiner is a Neurosurgery provider in Canton, Ohio. Dr. Weiner and is rated as an Advanced provider by MediFind in the treatment of Normal Pressure Hydrocephalus. His top areas of expertise are Hydrocephalus, Cerebellum Agenesis Hydrocephaly, Subdural Hematoma, Laminectomy, and Vertebroplasty. Dr. Weiner is currently accepting new patients.

What is the outlook (prognosis) for Normal Pressure Hydrocephalus?

Without treatment, symptoms often get worse and could lead to death.

Surgery improves symptoms in some people. Those with mild symptoms have the best outcome. Walking is the symptom most likely to improve.

What are the possible complications of Normal Pressure Hydrocephalus?

Problems that may result from NPH or its treatment include:

  • Complications of surgery (infection, bleeding, shunt that does not work well)
  • Loss of brain function (dementia) that becomes worse over time
  • Injury from falls
  • Shortened life span
When should I contact a medical professional for Normal Pressure Hydrocephalus?

Contact your provider if:

  • You or a loved one is having increasing problems with memory, walking, or urine incontinence.
  • A person with NPH worsens to the point where you are unable to care for the person yourself.

Go to the emergency room or call 911 or the local emergency number if a sudden change in mental status occurs. This may mean that another disorder has developed.

What are the latest Normal Pressure Hydrocephalus Clinical Trials?
Endoscopic Third Ventriculostomy Compared to Ventriculoperitoneal Shunt as Treatment for Idiopathic Normal Pressure Hydrocephalus (ENDOVEST): A Randomized Trial

Summary: The aim of this single-center, two-arm, open-labeled, randomized controlled clinical study is to compare two surgical interventions, endoscopic third ventriculostomy and ventriculoperitoneal shunt, in treating idiopathic normal pressure hydrocephalus in terms of clinical improvement.

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A Placebo-Controlled Efficacy in iNPH Shunting (PENS) Trial

Summary: The Placebo-Controlled Efficacy in Idiopathic Normal Pressure Hydrocephalus (iNPH) Shunting (PENS) trial is a multi-center blinded, randomized, placebo-controlled design investigation of cerebrospinal fluid (CSF) shunt surgery to study the shunt efficacy in iNPH patients.

Who are the sources who wrote this article ?

Published Date: March 31, 2024
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Frim DM, Vivas-Buitrago T, Rigamonti D, Lacy M. Surgical management of hydrocephalus in the adult. In: Quiñones-Hinojosa A, ed. Schmidek and Sweet: Operative Neurosurgical Techniques. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 81.

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In:  Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's  Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 88.

Sivakumar W, Drake JM, Riva-Cambrin J. The role of endoscopic third ventriculostomy: a critical review. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 45.