Normal Pressure Hydrocephalus
Other Tests to Evaluate Normal Pressure Hydrocephalus
Lumbar puncture (spinal tap): This procedure involves removal of CSF from the area around the spinal cord in the lower back.
- The CSF pressure is measured, and the fluid that is removed is analyzed for abnormalities that might give a clue as to the problem.
- Usually, more fluid is removed than is necessary for these tests. The idea behind this is that removal of a large volume of CSF helps relieve symptoms (this is checked by comparing exam results before and after).
- This effect usually is only temporary. However, improvement of symptoms with lumbar puncture is commonly interpreted as meaning that a surgical shunt would be helpful in that person.
What Is the Treatment for Normal Pressure Hydrocephalus?
Normal pressure hydrocephalus generally cannot be cured. It is a long-term condition. However, many people with the condition obtain substantial relief through surgical treatment. For those who are not candidates for surgery, treatment consists of measures to relieve mood and behavioral problems, cope with physical problems such as incontinence and walking difficulties, and maximize physical, mental, and social functioning.
Self-Care for Normal Pressure Hydrocephalus
An individual with normal pressure hydrocephalus should always be under the care of a medical professional. Much of the day-to-day care, however, is handled by family and caregivers. Medical care should focus on optimizing the individual's health, safety, and quality of life while helping family members cope with the many challenges of caring for a loved one with dementia and other symptoms of NPH.
The degree of care required by people with NPH varies considerably. Those who undergo successful shunt surgery may continue to live a normal or near-normal independent life. Others will experience worsening of their symptoms over time. Many of these individuals will eventually require close supervision and care. Your neurologist or neurosurgeon should discuss with you and your family what to expect as time goes on.
It's important to know that no drug or other medical treatment is known to work in NPH.
Surgery for Normal Pressure Hydrocephalus
Normal pressure hydrocephalus is not caused by any structural abnormality, such as a brain tumor. In most cases, the underlying problem is not known or cannot be treated. The treatment in these cases is a shunt operation.
A shunt is a thin tube that is implanted in the brain by a neurosurgeon. It is inserted into the ventricles to drain excess CSF away from the brain. The tube is routed under the skin from the head to another part of the body, usually the peritoneum (the lower belly). The shunt is equipped with a valve that opens to release fluid when the pressure builds up. The fluid drains harmlessly and is later absorbed by the bloodstream. The pressure setting on the valve sometimes must be readjusted. The newer shunts allow adjustment without another operation.