Normal pressure hydrocephalus overview

August 27, 2011 By

DEAR DR. GOTT: Could you please write about normal pressure hydrocephalus? I heard from a colleague that his mother, diagnosed with dementia, incontinence and weak knees, was instead diagnosed with this. She went to the Mayo Clinic and had a shunt put in her head to relieve the pressure on her brain. Subsequently, all the negative symptoms were alleviated, and she could resume fairly normal independent living.

The Internet says this condition is often misidentified as dementia. What say you?

DEAR READER: Normal pressure hydrocephalus (NPH) is defined as an abnormal increase in cerebrospinal fluid in the cavities of the brain. The condition occurs because the brain does not reabsorb the fluid, which normally circulates around the brain and spinal cord. [Read more...]

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Three Conditions Share Symptoms

January 11, 2009 By

DEAR DR. GOTT:
A relative of mine has been diagnosed with Parkinson’s disease. We have found that normal pressure hydrocephalus (NPH) has many of the same symptoms. Would you please explain the difference between the two diseases and advise the correct treatments?

DEAR READER:
First, I will briefly discuss hydrocephalus.

The body produces about eight ounces of cerebrospinal fluid (CSF) each day. Almost all of that fluid is reabsorbed into the bloodstream. When this fails to occur, as with head injury, stroke, meningitis or when a tumor develops, an imbalance occurs. This problem is known as hydrocephalus. There are two known forms, congenital and acquired. Congenital hydrocephalus generally occurs at birth. The acquired form (NPH) most frequently occurs in individuals over the age of 60.

Now, the problem. Symptoms include gait abnormalities, difficulty walking up and down stairs, confusion, urinary frequency and urgency, and short term memory loss. As you pointed out, these are also symptoms tied to Parkinson’s and also to Alzheimer’s.

Normal pressure hydrocephalus differs from congenital hydrocephalus in that pressure in the head may have fluctuations of CSF from high to low or even normal. Some cases are linked to bleeding in the brain or result from a blockage in the flow of CSF through and around the brain and spinal cord. [Read more...]

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Daily Column

September 4, 2008 By

DEAR DR. GOTT:
I hope you can help me with an issue that has been bothering me.

To the best of my knowledge there is no test for Alzheimer’s disease. It can only be diagnosed after death so how is it that people and doctors can say that someone’s symptoms are caused by it? How is it that a doctor can say that someone has early Alzheimer’s if there is no test for diagnosis? Is he or she simply guessing or assuming? I also would like to know about NPH which also has no test or diagnosis until after death.

DEAR READER:
You are mistaken. While you are correct that Alzheimer’s has no medical test, it can be diagnosed based on symptoms. Certain criteria must be met to make the diagnosis; however, it does not have to be a mystery illness, diagnosed only after death.

As for Normal Pressure Hydrocephalus (NPH), tests, primarily MRI, are available to confirm a diagnosis. [Read more...]

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