Normal pressure hydrocephalus (NPH) is a brain disorder characterized by excess accumulation of cerebrospinal fluid (CSF) in the brain's ventricles (fluid-filled chambers). Despite this buildup, the pressure of the fluid, when measured, is often within a normal or slightly elevated range, which is why it is called "normal pressure" hydrocephalus. The excess CSF causes the ventricles to enlarge, which compresses surrounding brain tissue and leads to neurological problems. NPH commonly affects older adults, usually those over 60 years old. The condition presents with a classic triad of symptoms:
- Difficulty walking or gait disturbances
- Cognitive impairments such as memory and thinking problems
- Loss of bladder control or urinary incontinence
NPH is often misdiagnosed as other neurodegenerative diseases like Alzheimer's or Parkinson's disease because of overlapping symptoms. However, it is important to recognize because it is one of the few treatable forms of dementia. The primary treatment is a surgical procedure to implant a shunt that drains excess CSF from the brain to another part of the body for absorption, which can alleviate symptoms. Causes of NPH can be idiopathic (unknown) or secondary to trauma, hemorrhage, or infection. The disease develops gradually and, if untreated, can cause permanent brain damage. In summary, NPH is a condition of abnormal CSF accumulation in the brain with normal pressure readings that leads to gait problems, cognitive decline, and bladder issues, mostly affecting older adults and potentially reversible with appropriate treatment.
