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Normal Pressure Hydrocephalus (NPH)
Frequently Asked Questions
What is Normal Pressure Hydrocephalus (NPH)?
NPH is a clinical syndrome that is characterized by gait
apraxia (a disorder of voluntary movement while walking),
incontinence (lack of bladder control) and dementia (deterioration
of intellectual faculties). Although the cause of NPH is not known
in most cases, some patients with NPH have a history of closed head
injury or subarachnoid hemorrhage. In all NPH cases, enlarged
ventricles are seen in the context of minimal atrophy of the brain.
Therefore, the increase in ventricle size is not due to tissue
loss, but rather due to changes in cerebral spinal fluid
(CSF).
How is NPH different from traditional
hydrocephalus?
The CSF pressures, when measured via lumbar puncture or ventricular
puncture, are normal in patients with NPH. Traditional
hydrocephalus always involves increased CSF pressure.
How do you diagnose NPH?
Currently, NPH is diagnosed by the symptoms listed above
in conjunction with brain imaging, lumbar puncture and/or drainage
of CSF.
How do you treat NPH?
By placement of a ventricular shunt, the neurosurgical standard of
care.
Is my NPH cureable?
NPH is not a hopeless situation. If the cause of NPH is
known, success rates can be as high as 80 percent. In cases in
which a cause is not known, the success rate varies from 25 to 74
percent.
What kind of lifestyle can I expect to have while I have
NPH?
The symptoms of abmornal gait, dementia and bladder
control may improve within days of shunt surgery, or may take weeks
to months to abate. Generally, patients with an implanted shunt
system are not restricted in their daily activities, except those
involving great physical exertion. Most patients can look forward
to a normal future. But because hydrocephalus is an ongoing
condition, patients do require long-term, follow-up care by a
doctor. Regular checkups are sensible and encouraged. |
NPH
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