Normal Pressure Hydrocephalus

This condition occurs mainly in older people when the ventricles slowly enlarge. Since the skull is not flexible, the brain thins to allow the ventricle to grow. This allows the pressure within the brain to remain normal.

This disease is typically seen in older people with the following symptoms:

• impaired thought processes starting with memory loss
• urinary incontinence, that is, inability to control urination
• bowel incontinence, that is, inability to control bowel movements
• loss of full control of body movements

The cause of this condition is unknown. Symptoms will worsen with lack of treatment. When thought processes and control of body movement become impaired, the person is at increased risk of injury from falling. Poor control of bowel and urinary function may result in urinary tract infections and skin breakdown.

There is no way to prevent normal pressure hydrocephalus.

Diagnosis is based on imaging studies such as a cranial MRI or cranial CT scan,

Lack of treatment may lead the person to become bedridden, psychotic, and completely unable to control bowel and/or urinary function.

There are no risks to others.

Treatment involves the surgical insertion of a ventriculoperitoneal shunt. The shunt drains cerebrospinal fluid from the enlarged ventricles of the brain, through a long tube into the abdomen. Doing this helps relieve the pressure on the ventricle walls, preventing further enlargement. The ventricle may also return to a relatively normal size.

Infection may occur after surgery. Occasionally, the ventriculoperitoneal shunt may not work properly.

Rehabilitation therapy can be provided to improve body movements, teach bowel and bladder control, and assist with other problems that interfere with everyday activities. Rehabilitation might include physical therapy, occupational therapy and speech therapy.

Monitoring involves watching for return of symptoms. This would indicate that the shunt is not working properly and might need to be repaired. Any new or worsening symptoms should be reported to the healthcare professional.