What is Normal Pressure Hydrocephalus (NPH)?
Normal pressure hydrocephalus is a brain disorder that typically affects people in the sixth or seventh decade of life. It occurs when there is an imbalance of cerebrospinal fluid (CSF), a naturally produced fluid that surrounds the brain and spinal cord. This cushioning fluid allows the brain to “float,” acting a bit like a shock absorber, thus protecting the brain from minor bumps.
When there is an imbalance in the production and absorption of CSF the fluid fills up within the ventricles of the brain, causing them to swell. This in turn compresses nearby brain tissue. A person may lose any or all brain functions controlled by the area of the brain that is compressed.
What are the symptoms of NPH?
The symptoms of NPH come on gradually – generally with the gait disturbance being noticed first. (The pattern of how a person walks is called their gait.) Additionally, there can be a decline in cognitive function, also known as dementia, and bladder function can become impaired.
What is the problem with walking or ones gait?
With NPH, there is typically a progressive problem with walking. Frequently, this is the first noticeable symptom. The person will have a slow shuffling gait with small steps. Some patients say they feel like their feet are glued to the floor or hard to pick up off the floor. When standing, patients tend to have a wide stance, with their feet far apart. There can be some difficulty negotiating steps and stairs.
How is NPH different from traditional hydrocephalus?
The CSF pressures, when measured via lumbar puncture or ventricular puncture, are normal in patients with NPH. Traditional hydrocephalus always involves increased CSF pressure.
How do you diagnose NPH?
Currently, NPH is diagnosed by the symptoms listed above in conjunction with brain imaging, lumbar puncture and/or drainage of CSF.
How do you treat NPH?
By placement of a ventricular shunt, the neurosurgical standard of care.
Is my NPH cureable?
NPH is not a hopeless situation. If the cause of NPH is known, success rates can be as high as 80 percent. In cases in which a cause is not known, the success rate varies from 25 to 74 percent.
