Normal Pressure Hydrocephalus

Cerebral spinal fluid or CSF is a protective fluid that circulates through the brain and spinal cord and drains into the circulatory system. Hydrocephalus is a condition characterised by an abnormal accumulation of cerebrospinal fluid inside the skull, increasing the internal pressure. Normal pressure hydrocephalus (NPH) is a type of hydrocephalus that develops slowly over time. Because the excess CSF builds up slowly, the increase in pressure is not as high as the other types of hydrocephalus. The exact cause of NPH is not clear. However, it may result from certain head injuries, bleeding from a blood vessel, infection, brain haemorrhage or complications of surgery.

Symptoms of NPH include:

• Impaired bladder control (sometimes bowel control problems may also occur)
• Difficulty walking, changes in gait and unsteadiness
• Decline in thinking skills, difficulty concentrating, forgetfulness and mood changes

NPH is diagnosed by reviewing your symptoms and performing a thorough physical examination. Your doctor may order tests such as MRI or CT scan of the head and lumbar puncture (involves the insertion of a needle into the spinal canal to obtain a sample of CSF for examination) to confirm the diagnosis.

Treatment involves surgical placement of a shunt in the brain to drain the excess CSF.