In the United States, there are an estimated 375,000 people suffering from normal pressure hydrocephalus (NPH). Of these, only about 11,500 have actually been treated with surgical implantation of a shunt – that’s less than 3% of those afflicted. This statistic is particularly significant when you consider that NPH is the only form of dementia that can be controlled or potentially reversed with treatment. Since NPH is often mistaken for other disorders, most cases of NPH go unreported and many are left untreated.
Normal pressure hydrocephalus is an excessive build-up of cerebrospinal fluid (CSF) in the ventricles of the brain occurring most often in people over the age of 60. Diagnosing NPH can be difficult because the key symptoms of the disease are also associated with other disorders like Alzheimer’s disease and Parkinson’s disease, as well as with the normal aging process. The number of cases of NPH is expected to grow as the elderly population increases.
Normal Pressure Hydrocephalus: Symptoms
Pressure created in the brain from the build-up of cerebrospinal fluid produces three basic symptoms in people with normal pressure hydrocephalus:
- Difficulty walking
- Mild dementia
- Impaired bladder control
Because these symptoms are also characteristic of other aging disorders and dementias, NPH can be difficult to diagnose.
Normal Pressure Hydrocephalus: Diagnosis
Normal pressure hydrocephalus may occur as the result of a head injury, cranial surgery, hemorrhage or bleeding during surgery, meningitis or other infection, tumor or cysts. However, in many cases the cause of this disorder is simply not known.
Your physician will perform a complete neurological examination and will likely follow up with neuroimaging tests (such as computerized tomography (CT) or magnetic resonance imaging (MRI) scans) and cerebrospinal fluid flow studies.
Normal Pressure Hydrocephalus: Treatment
A shunt is the most common and usually the only available treatment for NPH. The shunt is surgically implanted to divert excess cerebrospinal fluid from the brain or spinal canal to another part of the body where it can be absorbed into the bloodstream. Due to recent advances in technology, neurosurgeons may adjust shunt system settings non-invasively during regular office visits.
Unfortunately, not all NPH patients are candidates for surgical implantation of a shunt. They must meet criteria identified during diagnostic testing. Your neurologist will make recommendations based on his or her examination and the findings of neuroimaging studies.
Normal Pressure Hydrocephalus: Resources
Alzheimer’s Disease Education and Referral (ADEAR) Center
PO Box 8250
Silver Spring, MD 20907-8250
Alzheimer’s Association National Office
225 N. Michigan Ave., Fl. 17
Chicago, IL 60601
24/7 Nationwide Contact Center: 1.800.272.3900
American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, Maryland 20871
Tel: 800-437-2423 or (301) 948-3244
Fax: (301) 258-9454
Association for Frontotemporal Dementias (AFTD)
100 North 17th Street
Philadelphia, PA 19103
Tel: 267-514-7221 or 866-507-7222
870 Market Street
San Francisco, CA 94102
Tel: 415-732-7040 or 888-598-3789
International Federation for Spina Bifida and Hydrocephalus
Tel: +32 (0)2 502 0413
Fax: +32 (0)2 502 1129
The Lewy Body Dementia Association, Inc.
912 Killian Hill Road, S.W.
Lilburn, GA 30047
National Institute of Mental Health (NIMH)
National Institutes of Health, DHHS
6001 Executive Blvd. Rm. 8184, MSC 9663
Bethesda, MD 20892-9663
Tel: 301-443-4513/301-443-8431 (TTY) 866-615-NIMH (-6464)