Normal pressure hydrocephalus (NPH) is a type of dementia caused by a buildup of cerebrospinal fluid in the ventricles of the brain. This fluid buildup leads ventricles to enlarge and eventually damages surrounding brain tissue, leading to cognitive impairment and symptoms like loss of bladder control and difficulty walking.

Symptoms

There are three main identifiable symptoms of NPH, which often develop very slowly and gradually over the progression of the disease. These symptoms are:

  • Cognitive impairment usually characterized by slowed thinking, planning, and decision-making abilities.
  • Declined walking abilities, also known as gait disturbance. NPH causes individuals to walk 'as if they're on a boat', with unsteadiness, leg weakness, and shuddering steps.
  • Loss of bladder control, which usually appears later than the other symptoms and further into the development of the condition.

Fluid buildup in the brain and NPH also leads to other symptoms outside these central three indicators. Many of these are common to dementia conditions, which may lead to a misdiagnosis of Alzheimer's disease. These further symptoms include:

  • Nausea
  • Headache
  • Blurred vision, difficulty focusing eyes
  • Memory loss
  • Personality and behavior changes
  • Apathy and withdrawal
  • Speech problems
  • Mood changes

Causes

While there is no known singular cause for normal pressure hydrocephalus, professionals have identified high risk factors for developing the affliction. It's been identified that NPH can occur because of:

  • Brain surgery complications
  • Brain tumors
  • Aneurysm or bleeding in the brain
  • Head injuries
  • Stroke
  • Meningitis
  • Other brain injuries, infections, or inflammation

However, the cause of NPH is often undetermined or unclear - many cases of NPH occur without any of these contributing factors.

Like other dementia conditions, NPH is most common in the geriatric population. It's found primarily in individuals in their 60s and 70s.

Treatments

While many NPH symptoms are similar to Alzheimer's disease symptoms, the good news is that unlike Alzheimer's disease, NPH is treatable and reversible to a certain point. While there are currently no effective medication-based or nonsurgical treatments for the affliction, a surgical procedure involving the insertion of a tube to drain excess brain fluid has shown very positive clinical results. Though NPH is not completely curable, this surgical procedure usually leads to substantial improvements in walking abilities, and minimal improvements in bladder control and cognitive impairment. For those unwilling or unable to go through surgery, medication can help alleviate and control symptoms.