Hydrocephalus, also known as “water on the brain,” is a condition that affects the flow of cerebrospinal fluid (CSF) in the brain. This vital fluid helps to cushion and protect the brain and spinal cord, but when there is an imbalance in its production, absorption, or circulation, it can lead to a condition called hydrocephalus. There are two types of hydrocephalus: communicating and non-communicating. Non-communicating hydrocephalus, also known as “obstructive” hydrocephalus, occurs when there is a blockage in the normal flow of CSF. This blockage can be due to various reasons, including tumors, infections, or bleeding in the brain.
One type of non-communicating hydrocephalus is called non-pressure hydrocephalus, also known as normal pressure hydrocephalus (NPH). NPH is a condition that primarily affects older adults, usually over the age of 60. It is estimated that approximately 700,000 people in the United States have NPH, and it is often misdiagnosed as Alzheimer’s disease or Parkinson’s disease.
What causes non-pressure hydrocephalus?
Non-pressure hydrocephalus occurs when there is an obstruction in the normal flow of CSF. This blockage can be caused by various factors, including:
1. Previous brain injury or infection: A previous head injury or infection can cause scarring or inflammation in the brain, leading to a blockage in the flow of CSF.
2. Brain tumors: Tumors can put pressure on and block the pathways through which CSF flows.
3. Brain hemorrhage: Bleeding in the brain can also cause scarring and blockage of CSF flow.
4. Congenital defects: Babies can be born with abnormalities in the brain that can lead to non-pressure hydrocephalus.
5. Idiopathic causes: In some cases, the exact cause of non-pressure hydrocephalus is unknown.
What are the symptoms of non-pressure hydrocephalus?
The symptoms of non-pressure hydrocephalus can vary from person to person. They may develop slowly over time, making it difficult to identify the condition in its early stages. The symptoms can also be similar to those of other neurological conditions, making diagnosis challenging.
The most common symptoms of non-pressure hydrocephalus include:
1. Difficulty walking: As the excess CSF builds up in the brain, it can put pressure on certain areas, affecting balance and coordination. This can lead to difficulty walking and a shuffling gait.
2. Cognitive decline: In some cases, non-pressure hydrocephalus can cause cognitive impairment, including memory loss, trouble concentrating, and confusion.
3. Urinary incontinence: The pressure on the brain caused by the excess CSF can also affect the bladder, leading to urinary incontinence.
4. Changes in mood and behavior: Some people with non-pressure hydrocephalus may experience changes in mood and behavior, such as irritability, depression, or apathy.
How is non-pressure hydrocephalus diagnosed?
Diagnosing non-pressure hydrocephalus can be tricky, as the symptoms can be vague and similar to other conditions. However, there are specific tests and procedures that doctors use to diagnose this condition, including:
1. Physical exam: During a physical exam, a doctor will check for any physical signs of non-pressure hydrocephalus, such as difficulty walking or changes in reflexes.
2. Imaging tests: CT scans and MRIs can help doctors visualize the brain and any potential blockages or abnormalities that may be causing the excess CSF buildup.
3. Lumbar puncture: Also known as a spinal tap, this test involves removing a small amount of CSF from the spinal canal and analyzing it for any abnormalities or signs of increased pressure.
4. Neuropsychological testing: This test involves evaluating a person’s cognitive abilities and can help to identify any changes in memory, concentration, or behavior.
Is there a treatment for non-pressure hydrocephalus?
The primary treatment for non-pressure hydrocephalus is the surgical placement of a shunt. A shunt is a thin tube that is inserted into the brain to redirect the excess CSF to another part of the body, such as the abdomen, where it can be reabsorbed.
The surgical procedure to place a shunt is called a ventriculoperitoneal (VP) shunt. During this procedure, a neurosurgeon will make a small incision in the scalp and drill a small hole in the skull to access the brain’s ventricles. The shunt is then inserted and connected to a valve that regulates the flow of CSF. The other end of the shunt is placed in another part of the body, usually the abdomen.
In some cases, a shunt may need to be replaced or adjusted due to blockage or infection. It is important for people with non-pressure hydrocephalus to have regular follow-up appointments with their doctor to monitor their shunt and overall health.
In addition to surgical intervention, physical therapy and occupational therapy may also be recommended to help manage symptoms and improve mobility and daily functioning.
In conclusion, non-pressure hydrocephalus is a condition that primarily affects older adults and can lead to significant physical and cognitive impairment if left untreated. If you or a loved one is experiencing symptoms of non-pressure hydrocephalus, it is essential to seek medical attention for proper diagnosis and treatment. With proper management, people with non-pressure hydrocephalus can lead fulfilling lives and maintain their independence. Remember, early detection is key, so do not hesitate to talk to your doctor if you have any concerns about your health.
