Hydrocephalus is a condition that affects the brain and occurs when there is an abnormal buildup of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain. This buildup can cause increased pressure within the brain, leading to various symptoms and potentially serious complications. However, there is a type of hydrocephalus known as non-pressure hydrocephalus that differs in its cause and treatment. In this article, we will explore what non-pressure hydrocephalus is, its symptoms, causes, and treatment.
What is non-pressure hydrocephalus?
Non-pressure hydrocephalus, also known as normal pressure hydrocephalus (NPH), is a type of hydrocephalus that occurs when there is a buildup of CSF in the ventricles of the brain, but without an increase in pressure. This condition typically affects older adults, with the majority of cases occurring in people over the age of 60.
Symptoms of non-pressure hydrocephalus
The symptoms of non-pressure hydrocephalus are similar to those of other types of hydrocephalus, but they may be more subtle and progress slowly. The classic triad of symptoms for NPH includes:
1. Gait disturbance – This refers to difficulty walking or maintaining balance. People with NPH may experience unsteadiness, shuffling steps, and difficulty walking in a straight line.
2. Cognitive decline – NPH can also cause changes in cognition, including memory loss, difficulty with problem-solving and decision-making, and changes in personality.
3. Urinary incontinence – As the condition progresses, people with NPH may also experience urinary incontinence, which can lead to accidents or frequent trips to the bathroom.
Other symptoms that may occur include headaches, nausea, and vision changes. It’s important to note that these symptoms can also be caused by other medical conditions, so it’s essential to consult a doctor for a proper diagnosis.
Causes of non-pressure hydrocephalus
The exact cause of NPH is not fully understood, but it is thought to be the result of an imbalance between the production and absorption of CSF. Normally, CSF is continuously produced and absorbed, maintaining a constant level. In NPH, there may be a blockage or reduced absorption of CSF, leading to its accumulation in the ventricles.
Risk factors for NPH include age, as well as certain medical conditions such as head injury, meningitis, subarachnoid hemorrhage, and brain tumors. However, in many cases, the cause of NPH is unknown.
Diagnosis of non-pressure hydrocephalus
Diagnosing NPH can be challenging because its symptoms are similar to other conditions such as Parkinson’s disease and Alzheimer’s disease. A medical history and physical exam will be done to assess symptoms and rule out other potential causes. Imaging tests such as MRI or CT scans may also be used to visualize the brain and assess the amount of CSF present.
Another crucial aspect of diagnosing NPH is performing a lumbar puncture, also known as a spinal tap. This involves inserting a needle into the lower back to remove a sample of CSF and measure its pressure. If the pressure is normal, this can support a diagnosis of NPH.
Treatment of non-pressure hydrocephalus
The primary treatment for NPH is surgery to drain the excess CSF from the brain. This is usually done by placing a shunt, a thin tube, into one of the ventricles to redirect the fluid to another part of the body where it can be absorbed. This procedure is relatively low-risk and can significantly improve symptoms in many cases.
Physical therapy may also be recommended to help improve gait and balance, while occupational therapy can assist with any cognitive changes and daily activities. In some cases, medications may be prescribed to manage specific symptoms, such as urinary incontinence.
In conclusion, non-pressure hydrocephalus is a type of hydrocephalus that primarily affects older adults and is characterized by a buildup of CSF in the brain without an increase in pressure. It can cause a range of symptoms, including gait disturbance, cognitive decline, and urinary incontinence. Early diagnosis and treatment with surgery can greatly improve symptoms and quality of life for those with NPH. If you or a loved one are experiencing any of the mentioned symptoms, it’s essential to seek medical attention for proper diagnosis and treatment.
