Disease Information for Normal pressure Hydrocephalus

Clinical Manifestations
Signs & Symptoms
Apraxic gait ('slipping clutch'/hesitant)
Basal ganglion signs
CNS symptoms/signs
Cognitive defect
Gait disturbance/abnormality
Impaired judgement/signs
Memory Loss in Elderly
Near recall/memory deficit/defect
Short term memory loss
Shuffling 'magnetic' gait
Staggering Gait
Unable to tandem walk/straight line
Incontinent/noncognizant type
Urinary Incontinence in Elderly
Urine Incontinence
Urine Urgency
Fatigue Tiredness in Elderly
Clinical Presentation & Variations
Presentation/Dementia Ataxia Urine incontinent
Disease Progression
Course/Chronic disorder
Course/Chronic only
Demographics & Risk Factors
Past History
Past history/Head injury
Past history/Meningitis
Past history/Subarachnoid hemorrhage
Sex & Age Groups
Population/Adult Aged Only
Diagnostic Test Results
Other Tests & Procedures
Lumbar puncture normal
Post-LP mental improvement/remove fluid
PATH/CNS/Scarring arachnoid villi
Isotope Scan
Isotope/Brain Ventricular reflux/CSF isotope injection
Isotope/Radionuclide cysternography/delay latency
CT Scan
CT Scan/Head Brain Abnormality
CT Scan/Head Enlarged brain ventricles
CT Scan/Head Ventricular dilatation/normal cortex
MRI/Head Brain Abnormal
MRI/Head Ventricular enlargement
Associated Diseases & Rule outs
Rule Outs
Acoustic neuroma
Alcohol dementia
Alzheimers disease
Cervical myelopathy
Creutzfeld-Jacob disease
Dementia, Lewy body type
Dementia, multiple-infarct type
Parkinsonism-dementia complex
Spondylosis, cervical
Associated Disease & Complications
Hydrocephalus, chronic acquired
Normal pressure hydrocephalus
Organic brain syndrome
Pseudodementia/Reversible dementia
Ataxia Disorder
Disease Mechanism & Classification
CLASS/CNS Ventricles disorder
CLASS/CSF fluid disorder (ex)
CLASS/Meninges/pia/arachnoid involvement (ex)
CLASS/Neurologic (category)
Pathophysiology/CNS Arachnoid granulation/imflammation
Pathophysiology/CSF absorption failure
Pathophysiology/CSF flow defect
Hakim Syndrome, Hakim Syndromes, Hakims Syndrome, Hakim's Syndrome, Hakim's Syndromes, Hydrocephalus low pressure, HYDROCEPHALUS NORMAL PRESSURE, Low pressure hydrocephalus, NORMAL PRESSURE HYDROCEPHALUS, Normal pressure hydrocephalus (disorder), Normal pressure hydrocephalus syndrome, Normal pressure hydrocephaly, NPH, NPH Normal press hydrocephal, NPH Normal pressure hydrocephalus, NPH (Normal Pressure Hydrocephalus), NPHs (Normal Pressure Hydrocephalus), Syndrome Hakim, Syndrome Hakim's, Syndromes Hakim, Syndromes Hakim's, Synonym/Communicating hydrocephalus,normal press., Synonym/NPH syndrome
Drug Therapy - Indication
SX/Cerebral ventricular shunt/CSF
SX/Ventriculoperitoneal/CSF shunt

A form of mostly compensated hydrocephalus characterized clinically by a slowly progressive gait disorder progressive intellectual decline, and URINARY INCONTINENCE; Spinal fluid pressure tends to be in the high normal range; This condition may result from processes which interfere with the absorption of CSF including SUBARACHNOID HEMORRHAGE, chronic MENINGITIS, and other conditions;------------------------ (From Adams et al, Principles of Neurology, 6th ed)-------------

Normal pressure hydrocephalus (NPH) is an abnormal increase of cerebrospinal fluid (CSF) in the brain"s ventricles; It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way; This causes the ventricles to enlarge, putting pressure on the brain; Normal pressure hydrocephalus can occur in people of any age, but it is most common in the elderly population; It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery; However, many people develop NPH even when none of these factors are present; In these cases the cause of the disorder is unknown; Symptoms of NPH include progressive mental impairment and dementia, problems with walking, and impaired bladder control leading to urinary frequency and/or incontinence; The person also may have a general slowing of movements or may complain that his or her feet feel "stuck"; Because these symptoms are similar to those of other disorders such as Alzheimer"s disease, Parkinson"s disease, and Creutzfeldt-Jakob disease, the disorder is often misdiagnosed; Many cases go unrecognized and are never properly treated; Doctors may use a variety of tests, including brain scans (CT and/or MRI), a spinal tap or lumbar catheter, intracranial pressure monitoring, and neuropsychological tests, to help them diagnose NPH and rule out other conditions; Treatment for NPH involves surgical placement of a shunt in the brain to drain excess CSF into the abdomen where it can be absorbed; This allows the brain ventricles to return to their normal size; Regular follow-up care by a physician is important in order to identify subtle changes that might indicate problems with the shunt; The symptoms of NPH usually get worse over time if the condition is not treated, although some people may experience temporary improvements; While the success of treatment with shunts varies from person to person, some people recover almost completely after treatment and have a good quality of life; Early diagnosis and treatment improves the chance of a good recovery------[NINDS NIH website 2006]---------------


External Links Related to Normal pressure Hydrocephalus
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)