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</a><h1 class="with-also" itemprop="name">Normal pressure hydrocephalus</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p><a test="test" href="./001571.htm">Hydrocephalus</a> is a buildup of spinal fluid inside the fluid chambers of the brain. Hydrocephalus means "water on the brain."</p><p>Normal pressure hydrocephalus (NPH) is a rise in the amount of cerebrospinal fluid (CSF) in the brain that affects brain function. However, the pressure of the fluid is usually normal.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>There is no known cause for NPH. But the chance of developing NPH is high in someone who previously had any of the following:</p><ul><li>Bleeding from a blood vessel or <a test="test" href="./001414.htm">aneurysm</a> in the brain (<a test="test" href="./000701.htm">subarachnoid hemorrhage</a>)</li><li>Certain head injuries</li><li><a test="test" href="./000680.htm">Meningitis</a> or similar infections</li><li>Surgery on the brain (<a test="test" href="./003018.htm">craniotomy</a>)</li></ul><p>As CSF builds up in the brain, the fluid-filled chambers (ventricles) of the brain swell. This causes pressure on brain tissue. This can damage or destroy parts of the brain.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms of NPH often begin slowly. There are three main symptoms of NPH:</p><ul><li>Changes in the way a person walks: difficulty when beginning to walk (gait apraxia), feeling as if your feet are stuck to the ground (magnetic gait)</li><li>Slowing of mental function: forgetfulness, difficulty paying attention, apathy or no mood</li><li>Problems controlling urine (<a test="test" href="./003142.htm">urinary incontinence</a>), and sometimes controlling stools (<a test="test" href="./003135.htm">bowel incontinence</a>) </li></ul><p>Diagnosis of NPH can be made if any of the above symptoms occur and NPH is suspected and testing is done.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will perform a physical examination and ask about the symptoms. If you have NPH, your provider will likely find that your walking (gait) is not normal. You may also have memory problems. </p><p>Tests that may be done include:</p><ul><li><a test="test" href="./003786.htm">Head CT scan</a> or <a test="test" href="./003791.htm">MRI of the head</a></li><li><a test="test" href="./003428.htm">Lumbar puncture</a> (spinal tap) with careful testing of walking before and right after the spinal tap</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Treatment for NPH usually requires surgery to place a tube called a shunt that routes the excess CSF out of the brain ventricles and into the abdomen. This is called a <a test="test" href="./003019.htm">ventriculoperitoneal shunt</a>.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Without treatment, symptoms often get worse and could lead to death.</p><p>Surgery improves symptoms in some people. Those with mild symptoms have the best outcome. Walking is the symptom most likely to improve.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Problems that may result from NPH or its treatment include:</p><ul><li>Complications of surgery (infection, bleeding, shunt that does not work well)</li><li>Loss of brain function (<a test="test" href="./000739.htm">dementia</a>) that becomes worse over time</li><li>Injury from falls</li><li>Shortened life span </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider if:</p><ul><li>You or a loved one is having increasing problems with memory, walking, or urine incontinence.</li><li>A person with NPH worsens to the point where you are unable to care for the person yourself. </li></ul><p>Go to the emergency room or call 911 or the local emergency number if a sudden <a test="test" href="./003205.htm">change in mental status</a> occurs. This may mean that another disorder has developed.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Hydrocephalus - occult; Hydrocephalus - idiopathic; Hydrocephalus - adult; Hydrocephalus - communicating; Dementia - hydrocephalus; NPH</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Patient Instructions</h2></div><div class="section-button"><button type="submit" aria-controls="section-carepnt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div name="Patient Instructions" class="section-body" id="section-carepnt"><ul class="side-nav"><li><a href="../patientinstructions/000149.htm">Ventriculoperitoneal shunt - discharge</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9567t.jpg" alt="Ventricles of the brain" title="Ventricles of the brain" class="side-img"/><a href="../imagepages/9567.htm">Ventricles of the brain</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Frim DM, Vivas-Buitrago T, Rigamonti D, Lacy M. Surgical management of hydrocephalus in the adult. In: Quiñones-Hinojosa A, ed. <em>Schmidek and Sweet: Operative Neurosurgical Techniques</em>. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 81.</p><p>Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. <em>Bradley and Daroff's Neurology in Clinical Practice</em>. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 88.</p><p>Sivakumar W, Drake JM, Riva-Cambrin J. The role of endoscopic third ventriculostomy: a critical review. In: Winn HR, ed. <em>Youmans and Winn Neurological Surgery</em>. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 45.</p></div></div></section>
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