NEUROSURGERY ARTICLES

NORMAL PRESSURE HYDROCEPHALUS (NPH)

by Laura Paré, M.D.

Normal Pressure Hydrocephalus, or NPH, is a non-genetic neurological disorder that normally occurs in adults 55-60 years or older. It is often misdiagnosed as Alzheimer's or Parkinson's Disease. NPH is caused by an excess amount of cerebrospinal fluid (CSF) within the spaces of the brain called ventricles. Normally, the amount of CSF that is produced is equal to the amount that is drained out. When the CSF produced is not properly drained, the ventricles can become enlarged, causing a distortion of nearby brain tissue. The enlargement of the ventricles and distortion of the surrounding brain tissue causes three main symptoms of NPH called "the triad." The NPH triad consists of difficulty walking, urinary incontinence, and memory problems. Walking difficulty is characterized by a wide-based, slow, shuffling gate; the feet may seem to be "stuck" to the floor. Urinary incontinence is characterized both by inability to reach the toilet in time and by loss of bladder control. The dementia, or memory difficulties, is characterized by reduced shortterm memory which can progress to difficulties performing normal daily activities.

NPH can be caused by brain injury from trauma, hemorrhage, or infection. For many patients who have no history of infection or brain injury, the cause may be aging of the brain, itself.

NPH can be treated surgically by placing a draining device, or shunt, to drain the excess CSF into the abdomen, where it will be absorbed. This allows the ventricles to return to their normal size and reduces the distortion of the brain tissues. The brain can then function properly and send the correct messages down to other parts of the body, resulting in better control of walking, bladder, and memory.

More NPH Information

• The Difference between NPH and Alzheimers, Parkinsons
• Robert Dunkle: Videos of Before and After Shunt Surgery
• Hope for People with Normal Pressure Hydrocephalus
• Hydrocephalus Association

University of California, Irvine • Irvine, CA 92697
(949) 824-5011
© 2006 The Regents of the University of California.
All Rights Reserved.

Comments & Questions: Privacy & Legal Notice
Copyright Inquiries