What is Normal Pressure Hydrocephalus


What is Normal Pressure Hydrocephalus

Normal pressure hydrocephalus (NPH) occurs when excess cerebrospinal fluid (CSF) amass in the brain's ventricles, which enlarges it. The condition leads to thinking and reasoning problems, loss of bladder control, and difficulty walking. It is relatively rare, and only around 700,000 Americans have this condition. The risk of developing the condition is higher for people over 60 years old.

Often, normal pressure hydrocephalus is also misdiagnosed as Alzheimer’s or Parkinson’s disease because of similar symptoms. In fact, less than 20% of those with NPH receive a proper diagnosis.

Normal pressure hydrocephalus can substantially improve after surgery. A device called shunt can be inserted to provide relief.


The abnormality in walking is a common symptom for people with NPH. Usually, the person walks with legs held wide apart, body bent forward, and shows difficulty moving the feet.

Other than this, a person can also experience poor bladder control and dementia. Mild dementia and other symptoms for people with NPH include:

  • Forgetfulness
  • Difficulty completing tasks
  • Short-term memory loss
  • Reduced concentration
  • Changes in personality and behavior
  • Dizziness
  • Urinary urgency
  • Incontinence


Normal pressure hydrocephalus is a potentially reversible dementia case. Sometimes, it can be treated with an insertion of a shunt through surgery. A shunt is a thin tube implanted in the brain that drains the excess cerebrospinal fluid. The surgery may provide a good outcome, but it can also increase the risk of health complications, such as infection, seizures, and even death.

Some surgical operations reported having significant improvement, while others don't. For some, the multiple surgical procedures only fixed walking abnormalities and not other symptoms.

Ventricular shunt surgery isn't a cure, but a means to relieve the symptoms of NPH. Therefore, the earlier the illness is diagnosed, the better the outcome of the surgery is. Medications like diuretics have been used, but they haven’t seemed to ease the symptoms. Currently, there are no non-surgical treatments for NPH yet.

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