Know NPH

Know the symptoms of NPH and get the help you need. Visit our list of centers that have expertise in NPH screening, diagnosis, treatment, and care.

What is Normal Pressure Hydrocephalus (NPH)?

Normal pressure hydrocephalus (NPH) is a build up of cerebrospinal fluid (CSF) in an area in the center of the brain called ventricles. This causes the ventricles to become enlarged, sometimes with little or no increase in intracranial pressure (ICP).

What are the Symptoms of NPH?

NPH is typically characterized by a triad of symptoms: 

  • Gait Disturbance
    • Difficulty walking or making turns, feeling like it’s hard to take the first step, balance issues, falling
  • Cognitive Impairment
    • Problems organizing or planning tasks, hard time multitasking, trouble listening or paying attention, short-term memory issues, feeling withdrawn, talking less, poor handwriting, trouble with simple math calculations
  • Impaired Bladder Control
    • Trouble “holding it”, not able to get to the bathroom fast enough, experiencing accidents

These three symptoms may not all occur at the same time. They can also emerge at different stages of the disease with varying levels of severity.

Who develops NPH?

NPH is most commonly seen in adults aged 60 or over.

  • A recent study estimates that 800,000 older Americans may be living with NPH, with an estimate that more than 80% of cases remain unrecognized or untreated.
  • Without appropriate diagnostic testing, NPH is often misdiagnosed as Alzheimer’s disease or Parkinson’s disease, stroke, or other neurodegenerative conditions. Sometimes the symptoms are mistakenly attributed to “normal aging”.

Where can I get help?

NPH is one of the few causes of dementia that can be improved through direct treatment. 

If you feel you may be experiencing symptoms of NPH, contact your primary care physician and share your concerns. They may order brain imaging (a CT scan or MRI) and/or refer to you a neurologist or to a center with expertise in the condition. 

Below is a list of centers that have expertise in NPH screening, diagnosis, treatment, and care, as well as participate in research studies on NPH. A current MRI from your referring physician may be required for an appointment with the below institutions.



University of California Davis
Department of Neurosurgery
Kiarash Shahlaie, MD, PhD

Appointments should be made through the UCD Referral Department at (800) 482-3284. Please indicate NPH.

Pacific Neuroscience Institute
Adult Hydrocephalus Center
Garni Barkhoudarian, MD
(310) 582-7450

Keck Medicine at USC
Department of Neurosurgery
Darrin Lee, MD

Request an appointment online.



University of South Florida
Department of Neurosurgery & Brain Repair
Naomi Abel, MD
Appointments: (813) 821-8034



Emory University
Department of Neurosurgery
Daniel Barrow, MD
Appointments: (404) 778-5770



University of Chicago
Department of Neurological Surgery
Peter Warnke, MD
Appointments: (773) 702-2123
Online Request Form



Indiana University
Department of Neurosurgery
Angela M. Richardson, MD, PhD
Appointments: (317) 963-1300



John Hopkins University
Cerebral Fluid Center
Appointments: Lisa Williams at (410) 550-4059



Mayo Clinic
Department of Neurosurgery
Benjamin Elder, MD, PhD
Appointments: (507) 405-2450

New York


Icahn School of Medicine at Mount Sinai
Peter Morgenstern, MD
Christina Curnias, PA
Appointments: (212) 241-0954

NYU Langone
James B. Golomb, MD
Appointments: (212) 263-5709



Atrium Wake Forest Baptist
Department of Neurosurgery
Daniel Couture, MD
Appointments: (336) 716-4081

Please note that a fax with a referral and insurance information should be sent to (336) 716-3065, ATTN: Dr. Couture prior to your appointment.



Cleveland Clinic
Center for Neurological Restoration

Sean Nagel, MD
Appointments: (216) 636-5860
Referrals MUST be faxed to (216) 444-1015 ATTN Movement Disorders or NPH



Oregon Health and Science University
Neurosurgery Clinic, South Waterfront
Ahmed Raslan, MD
Appointments: (503) 494-4314



UT Southwestern
Departments of Neurology and Neurosurgery

Appointments for Initial Evaluation: (214) 645-8300

Patients who have already had imaging and an evaluation can schedule an appointment by calling (214) 645-2300 or making an online appointment request with Dr. Jon White. Initial evaluation paperwork is required.



University of Washington
Department of Neurological Surgery at the Harborview Medical Center
Michael A. Williams, MD
Appointments: (206) 520-5000



University of British Columbia
Thomas Zwimpfer, MD, PhD

University of Calgary
Mark Hamilton, MD



Umea University
Jan Malm, MD

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