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Normal pressure hydrocephalus (NPH)
Hydrocephalus is a build-up of fluid inside the skull, which leads to brain swelling. Hydrocephalus means "water on the brain."
Normal pressure hydrocephalus (NPH) is a rise in cerebrospinal fluid (CSF) in the brain that affects brain function. However, the pressure of the fluid is usually normal.
Hydrocephalus - idiopathic; Hydrocephalus - adult; Hydrocephalus - communicating; Extraventricular obstructive hydrocephalus
Causes, incidence, and risk factors
NPH may be caused by:
As CSF fluid builds up in the brain, the fluid-filled chambers (ventricles) of the brain swell. This causes pressure on brain tissue. This can damage or destroy parts of the brain.
You are more likely to get NPH if you have:
NPH is thought to play a role in some types of dementia.
The symptoms often begin slowly.
A person needs to have three symptoms to be diagnosed with normal pressure hydrocephalus:
Sudden falls without a loss of consciousness or other symptoms (drop attacks) may occur early in the illness.
Note: Many of these symptoms are common in the elderly, and may be caused by other conditions.
Signs and tests
An examination shows walking (gait) changes related to the pressure placed on parts of the brain. Deep tendon reflexes may be increased in the lower legs.
Some patients improve a lot after this surgery, but many do not. Walking is the symptom most likely to improve. No specific symptoms or test results can accurately predict which patients are most likely to get better after surgery.
See: Dementia - homecare for information about taking care of a loved one with dementia.
Without treatment, symptoms often get worse and could lead to death.
Surgical treatment improves symptoms in a percentage of patients. People with minimal symptoms have the best outcome.
Calling your health care provider
Call your health care provider if:
Go to the emergency room or call the local emergency number (such as 911) if a sudden change in mental status occurs. This may mean that another disorder has developed.
Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 63.
Reviewed by:A.D.A.M. Health Soutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang. Previously reviewed by Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network (2/16/2012).
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