What is normal pressure hydrocephalus?

Hydrocephalus is a condition in which the cerebrospinal fluid that encases and cushions the brain doesn’t absorb again into the bloodstream as it should.

This causes the ventricles to enlarge, which, in turn, causes more pressure on the brain.

The enlargement compresses brain tissue and can cause cognitive impairment.

Normal pressure hydrocephalus is a type of hydrocephalus that typically occurs in older adults, usually older than 60.

It differs from other types of hydrocephalus as it develops slowly over time.

The drainage of the cerebrospinal fluid is gradually blocked and the excess fluid builds up slowly, still causing the enlarged ventricles to press on the brain, which makes the term “normal pressure” very misleading.

NPH can result from head trauma, hemorrhage, infection or complications from surgery. But, some people can develop NPH without any of these conditions.

Progressive mental impairment and dementia, problems with walking, balance and urinary incontinence are some symptoms which are similar to symptoms of Alzheimer’s and Parkinson’s, so the disorder is often misdiagnosed. However, unlike Alzheimer’s and Parkinson’s, NPH can be reversed in many individuals with appropriate treatment, but it must be first correctly diagnosed.

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 diagnose NPH and rule out other conditions. With an early diagnosis, treatment for NPH can be started immediately.

Treatment for NPH involves a surgical placement of a shunt in the brain to drain the excess cerebrospinal fluid into the abdomen where it can be absorbed as part of the normal circulatory process.

The brain ventricles can then turn to their normal size. Although treatment is often successful, the shunt procedure carries significant risk and outcomes vary from person to person.

Questions about Alzheimer’s disease or a related dementia disorder? Contact Dana Territo, the Memory Whisperer, Director of Services at Alzheimer’s Services of the Capital Area, (225) 334-7494, advice@alzbr.org, or visit the organization at 3772 North Blvd., Baton Rouge.