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Normal Pressure Hydrocephalus

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How Is Normal Pressure Hydrocephalus Diagnosed? continued...

Neuropsychological testing is the most accurate method of pinpointing and documenting a person's cognitive problems and strengths.

Lab Tests

There is no lab test that confirms the diagnosis of NPH. Any lab tests that are done are probably being done to rule out conditions that might cause similar symptoms.

Imaging Tests

  • CT scan of the head: This scan is similar to an X-ray but gives a more detailed, 3-dimensional picture of the brain. It cannot confirm a diagnosis of NPH, but it can show ventricular enlargement or other changes that suggest NPH. Newer techniques can actually measure the flow of CSF in the brain. These findings alone may not be sufficient for diagnosis. This scan is safe and painless.
  • MRI of the head: This scan uses radio signals and a strong magnet to create a detailed picture of the brain. It is safe and painless, like a CT scan, but takes longer (about 30 minutes). It also cannot confirm a diagnosis of NPH.
  • Cisternography: This test is much more involved than CT scan or MRI and is not widely used. It highlights absorption of the CSF.

 


 

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 being that removal of a large volume of CSF may help relieve symptoms (this is checked by comparing exam results before and after). 

If symptoms are relieved, it is usually temporary; 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.

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