Normal Pressure Hydrocephalus (NPH) is a type of hydrocephalus (abnormal buildup of cerebrospinal fluid in the ventricles of the brain, which leads to increased intracerebral pressure). This condition develops slowly over time and usually affects older adults.
NPH is characterized by a triad of symptoms, which include gait disturbance, early stage dementia, and urinary incontinence. However, since the symptoms typically occur over time, and not all of them are required, this can be a challenging diagnosis. Typically, gait disturbance presents first and is the most significant problem. It manifests by a slow gait, shuffling steps and a wide stance. Subtle mental deterioration and incontinence generally occur at a later stage. Therefore, NPH is often confused with Alzheimer’s or Parkinson’s diseases, or just accepted a normal part of getting old.
Early diagnosis allows for timely treatment and can rule out other conditions, some of which may be life threatening, such as subdural hematoma, brain tumor, or intracranial infection. The following routine tests are performed to diagnose NPH: neuropsychological testing, CT or MR scans, and CSF lumbar drainage test. The later test not only helps to diagnose NPH, but also is a good indicator of a positive shunt outcome.
There is currently no cure for this disease, but symptoms can be substantially relieved after undergoing a shunt operation. Physicians at Boulder Neurosurgical & Spine Associates (BNA) have long been involved with patients suffering from this syndrome. Our multidisciplinary team confirms the initial diagnosis, puts the appropriate treatment plan in place, and provides surgical expertise to patients. There are different types of surgical interventions, which sometimes involve shunting procedures that can be very effective in the management of NPH.
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