Normal Pressure Hydrocephalus: gradual fluid buildup in brain, mostly in the elderly. Can cause brain damage.
Hydrocephalus is commonly referred to as water on the brain (in Greek "hydro" means water and "cephalus" means head). Hydrocephalus is a condition in which there is an excessive accumulation of fluid within the skull. This fluid is not actual water; rather it's cerebrospinal fluid. The abnormal buildup of cerebrospinal fluid (CSF) can lead to pressure on the brain.
Cerebrospinal fluid (CSF) is a clear fluid that surrounds the spinal cord and brain. A few of the functions of CSF include acting as a shock absorber, transporting nutrients, removal of waste, and regulating pressure in the brain. The body continuously produces and absorbs CSF; therefore anything that affects either of these can lead to an imbalance. Also, anything that interrupts the normal flow of CSF can create its buildup and the resulting pressure on the brain.
An excess of pressure on the brain is potentially harmful; thus hydrocephalus can cause permanent brain damage and even death. However, with appropriate treatment, most patients are able to lead normal lives with few limitations.
Normal pressure hydrocephalus is an adult onset form of hydrocephalus. It develops slowly over time and therefore differs from other types of hydrocephalus. This means that the drainage of cerebrospinal fluid (CSF) is gradually blocked, and the fluid buildup occurs slowly. It also means that symptoms often develop slowly and over a long period of time. The gradual buildup of CSF in the ventricles means that the resulting pressure within the brain may not be as much as in other forms of hydrocephalus. However, the “normal” part of the name of this condition is misleading because some patients actually do have changes in pressure (i.e., the amount of pressure is not normal).
Normal pressure hydrocephalus occurs due to a blockage in the areas where the cerebrospinal fluid (CSF) drains after exiting certain structures in the brain (ventricles). Since drainage is blocked, the amount of CSF in these structures starts to accumulate and they become enlarged. These enlarged ventricles can then compress the brain and cause damage to it.
Although normal pressure hydrocephalus can occur at age, it typically occurs in adults over 60 years of age.
Normal pressure hydrocephalus can be the result of any condition that blocks the flow of cerebrospinal fluid including:
Symptoms can begin slowly and be difficult to identify. It’s thought that normal pressure hydrocephalus accounts for approximately 5% of all cases of dementia.
Primary symptoms of normal pressure hydrocephalus include:
Normal pressure hydrocephalus is estimated to impact 0.5% of the population over 65 years of age. Unfortunately, its symptoms are common in elderly patients, and may have other causes. Because symptoms often develop slowly and over a long period of time, they can be mistaken as part of the normal aging process.
A physician may perform following to diagnosis normal pressure hydrocephalus:
Without treatment, symptoms often continue to get worse and can lead to death. Surgical treatment improves symptoms in many patients; however, not all patients see improvement in their symptoms. There is no way to accurately predict which patients will improve with surgery, although those with minimal symptoms generally have the best outcomes. If a patient’s symptoms improve with cerebral spinal fluid drainage, then surgery is generally recommended.