Normal Pressure Hydrocephalus

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Normal pressure hydrocephalus (NPH) is an accumulation of cerebrospinal fluid (CSF) that causes the ventricles in the brain to become enlarged, sometimes with little or no increase in intracranial pressure (ICP). In most cases of NPH, the cause of blockage to the CSF absorptive pathways is unclear. The name for this condition, ’normal pressure hydrocephalus,‘ originates from Dr. Salomon Hakim’s 1964 paper describing certain cases of hydrocephalus in which a triad (a group of three) of neurologic symptoms occurred in the presence of ’normal‘ CSF pressure –  gait disturbancesdementia, and impaired bladder control. These findings were observed before continuous pressure-recording techniques were available. The phrase ‘normal pressure’ is misleading as many patients experience fluctuations in CSF pressure that range from high to low and are variable within those parameters. However, normal pressure hydrocephalus (NPH) continues to be the common name for the condition.

Who develops Normal Pressure Hydrocephalus?

NPH is most commonly seen in older adults.

  • It is estimated that more than 700,000 Americans have NPH, but less than 20% receive an appropriate diagnosis.
  • Without appropriate diagnostic testing, NPH is often misdiagnosed as Alzheimer’s disease or Parkinson’s disease, or the symptoms are attributed to the aging process.
  • NPH is one of the few causes of dementia that can be controlled or reversed with treatment.

Click here to watch our video WHAT IS NPH?
Click here to download our booklet About Normal Pressure Hydrocephalus.

6 Comments for : Normal Pressure Hydrocephalus
  1. Reply

    My husband was diagnosed with NPH almost 2 yrs. ago. He walks very slowly now and needs either a cane or a walker. His memory has declined in that time and his thinking process is most certainly compromised. We hesitate about the shunt because of the poor results–only 25-75% have SOME help, but it is the only recourse we know there is for treatment. From last years MRI and test results in appears that his condition is only slowly deteriorating although I see much change in his condition since last year. Is there a particular website or association besides this one where additional updated info is available?

    • Elizabeth
    • March 19, 2017
    Reply

    I have recently been diagnosed with nph and am going to have surgery. Any recommendations for physical therapy following the surgery?

    • Barbara Brown
    • June 20, 2016
    Reply

    I have dealt with NPH for over 8 years as a caretaker. If I wrote a big it would be a guaranteed best seller. I see people almost daily that I recognize the NPH symptoms affecting them and will stop and talk with them and tell them about NPH. Several have gone for tests and had the shunt put in and walked off the operating room table. Not enough information is available or stories published regarding NPH. Knowledge is the lifesaving power to correct those that may be afflicted with it and have it blamed on Alzheimers, Dimentia or Parkinsons. So sad.

      • Jan
      • January 27, 2017
      Reply

      Hi Barbara
      I am really worried about my mum. She is a very youthful 68. Recently retired from a very stressful job. Showing signs of PSP but the doctors have not given a diagnosis yet. Her symptoms are: slowness in movement, difficulty finding words and slurring, forgetfulness, gaze problems. Do you think NPH is to be ruled out based on these symptoms or is it possible to have these symptoms with NPH? Her MRI and DaTSCAN were normal

      • Jean Cary
      • February 11, 2017
      Reply

      I have NPH and was lucky enough to be diagnosed after about 4 years of worsening symptoms. (not able to be diagnosed by university of Pennsylvania)

      I was diagnosed by by brother’s DO when I came to Las Vegas to help him with his medical issues.

      I’m convinced that a lot of folks, including some in the memory care facility where I’m staying now, could be helped by an accurate diagnosis and treatment.

      As soon as I get into my next placement, I want to add my efforts to advocating for greater awareness of NPH. For now, I’m trying to get into an assisted living program offering a variety of services that will help me improve further. I am interested in more information about the personal experiences that patients and caregivers can offer, such as how long it’s taken for improvement,etc.

      PS, I’ve worked for many years, most recently as a disability lawyer.

      • Jean
      • March 14, 2017
      Reply

      I agree that the condition is not diagnosed enough, given what can happen to some folks who become extremely disabled without treatment, as happened to me. Fortunately, I was able to get surgery and improved, but I suffered the effects of lack of treatment.

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