Facts about Normal Pressure Hydrocephalus, Commonly Experienced by the Elderly
Hydrocephalus is a condition of fluid accumulation in the brain. The excess fluid puts pressure on the brain which can damage it. If left untreated, hydrocephalus can be fatal.
There are three main types of hydrocephalus, namely:
Congenital hydrocephalus: Hydrocephalus present at birth. Acquired hydrocephalus: Hydrocephalus that develops after birth. Normal pressure hydrocephalus: Usually only develops in the elderly. Well, through this article you will be invited to understand normal pressure hydrocephalus.
- Causes and risk factors for normal pressure hydrocephalus The brain has chambers called ventricles which are usually filled with fluid. This fluid is called cerebrospinal fluid (CSF). It cushions the brain and spinal cord, citing Johns Hopkins Medicine .
Normally the body produces enough CSF each day and absorbs the same amount. Sometimes, however, too much fluid can build up in the ventricles. This can lead to normal pressure hydrocephalus (NPH).
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The cause of excess fluid in the ventricles of the brain can be due to injury, bleeding, infection, brain tumor, or surgery on the brain. However, the cause is often unknown (idiopathic). When excess fluid builds up in the ventricles, they expand and compress nearby brain tissue. This extra fluid and pressure can cause brain damage.
NPH, although rare, most commonly affects the elderly and its symptoms can be similar to those of Alzheimer's , Parkinson's, and Creutzfeldt-Jakob disease . Doctors familiar with these conditions can often tell the difference between them and NPH after special testing.
Your risk of NPH increases if you:
Over 60 years old. Have a brain infection. Have had a head injury. Have a brain tumor . Have had brain surgery. There are two forms of NPH and these occur to the same extent. The two types are primary (idiopathic) NPH and secondary NPH.
Primary NPH means it is not due to another medical condition, also known as idiopathic NPH, which occurs for an unknown reason. Experts suspect that idiopathic NPH may involve one or more age-related problems with the way the body makes, circulates, and reabsorbs CSF. About half of NPH cases are idiopathic.
Secondary NPH occurs when another medical condition affects how the body makes, circulates, or reabsorbs CSF. Some examples of conditions that can cause secondary NPH include:
Brain aneurysm . Intracranial bleeding. Brain tumor. Infection of the brain or related areas of the nervous system, such as encephalitis or meningitis . Stroke. Traumatic brain injury, which can also include injury in or around the brain as a result of medical procedures.
- Symptoms of normal pressure hydrocephalus Described on the National Institute of Neurological Disorders and Stroke website , NPH symptoms can include progressive mental disorders and dementia, problems walking, and impaired bladder control.
In addition, people with NPH may also experience a general slowing of movement or may complain that their feet feel "stuck."
In full, the following are possible symptoms of NPH:
Problems walking (feeling like your feet are stuck in the ground). Bad balance. fall Changes in gait. Mood swings. Depression. Difficulty in responding to questions. Loss of urinary control.
Because the symptoms of NPH are similar to those of other disorders such as Alzheimer's disease, Parkinson's disease , and Creutzfeldt-Jakob disease, it is often misdiagnosed. Many cases are not recognized and never handled properly. Therefore, it takes a doctor who is familiar with this condition to detect it.
- Diagnosis of normal pressure hydrocephalus Because the symptoms of normal pressure hydrocephalus are similar to those of Alzheimer's, Parkinson's, and Creutzfeldt-Jakob disease, NPH is often overlooked or misdiagnosed. The three symptoms of normal pressure hydrocephalus are considered the "classic" clinical features, but not everyone with NPH experiences all three symptoms.
In a Mayo Clinic study , among 41 older adults with suspected NPH, all had difficulty walking, 30 experienced cognitive decline, and 14 reported loss of bladder control. Only 12 out of 41 had all three symptoms.
Reported by the Alzheimer's Association , to confirm a diagnosis of NPH, one or more of the following tests may be performed:
Brain imaging: Imaging of brain structures to detect ventricular enlargement, often with MRI or CT scan imaging , plays a key role in diagnosing NPH. Several brain disorders, including Alzheimer's disease, can cause overall shrinkage of brain tissue that makes the ventricles appear larger than normal. In NPH, brain tissue may not appear to shrink even though the ventricles are enlarged. Clinical examination: Because the clinical picture for NPH can vary and symptoms may overlap with those of Alzheimer's and other dementias, experts recommend that a person with suspected NPH be examined by a neurologist with extensive experience evaluating brain disorders that affect movement, thinking skills, and function. physical. CFS test: CSF tests to predict shunt response and/or determine shunt pressure include lumbar puncture, external lumbar drainage, measurement of CSF outflow resistance, intracranial pressure (ICP) monitoring, and isotopic cisternography .
- Treatment of normal pressure hydrocephalus NPH is one of the few causes of dementia that can be controlled or reversed with treatment. If symptoms and results from evaluation and MRI suggest NPH, high-volume lumbar puncture can be used to identify whether a person has the potential to benefit from surgical insertion of a shunt .
In this procedure, the doctor removes a large amount of spinal fluid and observes the individual for 30 to 60 minutes, looking for improvement in walking or thinking and reasoning. Most people who are initially suspected of having NPH do not improve after having a cerebrospinal fluid excretion test.
Researchers have not found effective nonsurgical treatments for NPH. Medications that remove excess fluid throughout the body, such as diuretics, do not seem to improve symptoms. Further research is needed to:
Understand the prevalence of normal pressure hydrocephalus. Show how the excess CSF involved in normal pressure hydrocephalus causes symptoms that affect movement, thinking, and bodily functions. Clarify possible benefits and ideal targets for shunt placement .
- Prevention of normal pressure hydrocephalus NPH occurs unexpectedly, and half of cases are idiopathic, meaning it occurs for an unknown reason. Idiopathic NPH can't be prevented, and you can't reduce your risk of having it.
However, you can reduce your risk of secondary NPH by avoiding the conditions or circumstances that can cause this condition. Here are some things you can do:
Don't ignore the infection. This is especially important for eye and ear infections, which can easily spread to the brain and cause encephalitis or meningitis. Wear safety equipment. Traumatic brain injury is a possible cause of secondary NPH. Wearing a helmet and other safety equipment can help you avoid head injuries that can cause this condition. Manage health conditions. Conditions such as high blood pressure can lead to problems such as aneurysms or bleeding in the brain, both of which can cause NPH. Controlling blood pressure and managing related conditions such as type 2 diabetes or high cholesterol can reduce the risk of these problems. Coping with the symptoms of NPH can be difficult for the sufferer and those around them. The condition affects every aspect of life, including family relationships, work, financial status, social life, and physical and mental health. Overwhelmed, depressed, frustrated, angry, or irritated may be felt. Those feelings don't help the situation and usually make it worse. In this case, joining a support group can make a big difference.
A support group is a group of people who are going through the same thing and want to help themselves and others by sharing coping strategies. Ask your doctor about this.
Normal pressure hydrocephalus is a rare condition that most often affects people over 65 years of age. This condition can occur for idiopathic reasons or due to other conditions. This condition causes dementia-like symptoms, affecting the way you walk, think, and the ability to control urination.
This condition is often treatable or even reversible. Chances of reversing the effect are best with early diagnosis and treatment. It is important not to ignore symptoms in yourself or your loved ones. With prompt treatment, many people can recover and regain most—if not all—of the abilities they had before developing this condition.