Normal Pressure Hydrocephalus (NPH)

Causes and Symptoms of Normal Pressure Hydrocephalus

Normal pressure hydrocephalus (NPH) with no known cause is considered idiopathic. Idiopathic NPH is most likely to occur in older adults. Secondary NPH can occur in younger people and usually has a determined cause:

• Head trauma
• Subarachnoid hemorrhage
• Inflammation or infections such as meningitis
• Tumors or cysts
• Neurosurgical complications

Symptoms tend to get progressively worse:

• Difficulties walking — this is often the first symptom to appear (and the first to be relieved by treatment). Patients may walk with a very wide stance and small, heavy steps.
• Mental impairment or mild dementia
• Bladder control issues — this often occurs later in the disease

Because these symptoms often occur in older patients and are similar to other age-related disorders, NPH can be misdiagnosed as Alzheimer’s disease, Parkinson’s disease or other dementias.

How Is Normal Pressure Hydrocephalus Diagnosed?

Accurate diagnosing of NPH involves neurological testing, brain imaging and cerebrospinal fluid (CSF) measuring.

A neurological exam can help detect dementia and other cognitive functioning issues. A neurologist knowledgeable about age-related disorders and neurological functioning is key to an informed diagnosis.

CT (computerized tomography) scans and an MRI (magnetic resonance imaging) help your doctor determine if the ventricles are enlarged and/or if they only appear dilated because the surrounding tissue has atrophied due to another condition.

If brain imaging shows a likelihood of NPH, CSF testing such as a large-volume spinal tap or lumbar puncture will extract cerebrospinal fluid to see if the reduction in CSF relieves symptoms temporarily. Intracranial pressure monitoring measures the degree of CSF blockage, and isotopic cisternography uses radioisotopes to determine the CSF absorption rate.

Stereotactic Radiosurgery

State-of-the-art Treatments for Normal Pressure Hydrocephalus at NSPC
As mentioned above, NPH patients are generally older, and the causes, symptoms, diagnosis and treatments for NPH are different than those for children with hydrocephalus.

NSPC Brain & Spine Surgery (NSPC) (NSPC), with our multidisciplinary teams of endovascular neuroradiologists, neurosurgeons, neurophysiologists, neuropsychologists and neuro-oncologists, has convenient office locations on Long Island and in the NYC metro area to treat serious brain conditions. As the NY region’s leading private neurosurgical practice, NSPC has physicians with a range of neurosurgical subspecialties and related fields.

Successful treatment for normal pressure hydrocephalus involves surgery to implant a shunt to drain the cerebrospinal fluid from the brain to another part of the body for reabsorption. Treatment involves balancing the production, flow and absorption of the fluid. A shunt’s valve helps stabilize CSF circulation and can have a fixed pressure or be adjustable.

NSPC neurosurgeons offer expert NPH treatments in state-of-the-art facilities. Depending on your specific situation, different shunts may be recommended:

• Ventriculoperitoneal shunt — the excess CSF is drained in the peritoneal cavity of the abdomen.
• Ventriculoatrial shunt — surplus CSF is diverted to the heart to be reabsorbed.
• Endoscopic third ventriculostomy — for patients with a stenosis (narrowing) of the sylvius aqueduct, the neurosurgeon creates another path for the CSF around the cerebral aqueduct blockage.

Our expert staff of specialists provides world-class treatments for a broad range of neurological conditions such as normal pressure hydrocephalus. Our aim is the best possible outcome for every patient. If you’d like to explore treatment options or seek diagnosis regarding the symptoms above, don’t hesitate to contact us.