Normal pressure hydrocephalus

Normal pressure hydrocephalus (NPH) is a neurological condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) in the brain's ventricles, causing them to enlarge.

Despite this fluid buildup, the pressure within the brain remains normal, which distinguishes NPH from other forms of hydrocephalus that typically present with elevated intracranial pressure.

This unique condition primarily affects older adults and is associated with a classic triad of symptoms: gait disturbance, urinary incontinence, and cognitive dysfunction, often resembling dementia.

The pathophysiology of NPH involves impaired CSF absorption, leading to ventricular dilation and subsequent pressure effects on adjacent brain structures.

This dilation primarily affects the brain's white matter and can disrupt neural pathways, contributing to the characteristic symptoms.

Diagnosing NPH usually involves neuroimaging techniques such as MRI or CT scans, which can identify ventricular enlargement.

A clinical assessment is critical, often supported by lumbar puncture tests that may temporarily improve symptoms, confirming the diagnosis.

Treatment typically involves surgical intervention with the insertion of a shunt system to divert excess CSF to another part of the body where it can be absorbed.

Early diagnosis and intervention are crucial, as some patients may experience significant improvements in symptoms post-surgery.

However, the condition can be challenging to diagnose, and not all patients respond to treatment, necessitating careful clinical evaluation and follow-up.