Normal Pressure Hydrocephalus/NPH

What Is Normal Pressure Hydrocephalus (NPH)?

Normal Pressure Hydrocephalus (NPH) is a neurological condition caused by a buildup of cerebrospinal fluid (CSF) in the brain’s ventricles. Despite the name, the pressure of the fluid may appear normal during testing, but the enlarged ventricles press on brain tissue, leading to symptoms that mimic dementia or Parkinson’s disease.

Who It Affects

• Most common in adults over age 60
• Affects up to 5.9% of people over 80
• Often misdiagnosed as Alzheimer’s, Parkinson’s, or normal aging

Symptoms of NPH

NPH is characterized by a triad of symptoms:

1. Gait disturbances: shuffling steps, imbalance, feeling like feet are “glued to the floor”
2. Cognitive decline: memory loss, confusion, slowed thinking
3. Urinary incontinence: urgency or loss of bladder control

Other symptoms may include:

• Depression or mood changes
• Difficulty responding to questions
• Loss of interest in daily activities

Causes and Risk Factors

NPH can be:

• Idiopathic (primary): no known cause
• Secondary: due to head injury, brain surgery, hemorrhage, infection, or tumor 

Risk factors include:

• Age over 60
• History of brain trauma or infection
• Prior neurosurgery

Diagnosis

Diagnosis involves:

• MRI or CT scans to detect enlarged ventricles
• Spinal tap (lumbar puncture) to test CSF pressure and symptom response
• Gait and cognitive assessments
• Lumbar drain trial for extended fluid removal

reatment Options

1. Shunt Surgery

• A ventriculoperitoneal shunt is implanted to drain excess CSF from the brain to the abdomen
• Proven to improve walking, balance, and independence in many patients
• Cognitive and bladder symptoms may also improve, though less predictably [Brain shun…rocephalus], [UCalgary r…rocephalus]

2. Non-Surgical Management

• Physical therapy
• Cognitive rehabilitation
• Symptom monitoring
• In select cases, temporary CSF drainage may offer relief

Call us at (561) 433-4444 to schedule a consultation or make an appointment.
Let our experienced doctors help you manage Normal Pressure Hydrocephalus and improve your quality of life.