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Alternative names Return to top
Hydrocephalus - idiopathic; Hydrocephalus - adult; Hydrocephalus - communicating, "water on the brain"Definition Return to top
Normal pressure hydrocephalus (NPH) is a brain disorder caused by blockage of the flow of cerebrospinal fluid, with enlargement of the ventricles within the brain and compression of the brain tissue. It may result in loss of any or all brain functions controlled by the area of the brain which is compressed.
Causes, incidence, and risk factors Return to top
Normal pressure hydrocephalus (NPH) can be a reversible or treatable disorder. It is thought to account for about 5% of all dementias. The incidence is 1 out of 100,000 people. NPH can occur at any age. The onset of symptoms is often gradual.
NPH is a form of hydrocephalus, also known as "water on the brain", which means there is too much fluid compressing the brain. It can occur without identifiable cause, or it may be caused by any condition where there is an obstruction to the flow of cerebrospinal fluid (CSF). The CSF is produced in normal amounts in this condition, but it is prevented from being normally re-absorbed.
The ventricles (fluid-filled chambers) of the brain enlarge to accommodate the increased volume of CSF so the pressure of CSF, when measured by lumbar puncture (spinal tap), remains normal. Brain tissue is damaged or destroyed because of compression by the fluid-filled ventricles. If there is an identifiable cause and the cause can be corrected, the symptoms may reverse or at least stop getting worse. If there is no identifiable cause, the disorder is often progressive.
Risk factors include disorders that may cause obstruction of the flow of CSF, such as closed head injury, surgery on the brain (craniotomy), meningitis or similar infections, and subarachnoid hemorrhage (bleeding from a blood vessel or aneurysm in the brain).
Symptoms Return to top
Early symptoms include:Signs and tests Return to top
An examination shows gait changes related to the damage within the brain. Deep tendon reflexes may be increased in the lower legs.Treatment Return to top
The goal of treatment is to improve symptoms. The surgical creation of a shunt that routes the CSF around the obstruction and back into the circulation is the treatment of choice.Expectations (prognosis) Return to top
Prognosis is poor without medical intervention. Symptoms progress and the disorder results in death.Complications Return to top
Calling your health care provider Return to top
Call your health care provider if symptoms indicate normal pressure hydrocephalus may be present.Prevention Return to top
Treatment of disorders associated with NPH may prevent its development in some cases. In other cases it may not be preventable, but early treatment may prevent progression to severe symptoms. Update Date: 4/25/2004 Updated by: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |