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Normal pressure hydrocephalus (NPH), also called malresorptive hydrocephalus, is a form of communicating hydrocephalus in which excess cerebrospinal fluid (CSF) builds up in the ventricles, leading to normal or slightly elevated cerebrospinal fluid pressure.
Normal pressure hydrocephalus (NPH) most often occurs in elderly patients with symptoms including gait disturbance, urinary incontinence, and cognitive issues. [33] It is commonly divided into two categories, idiopathic NPH (with unknown cause) and secondary NPH (due to trauma, hemorrhage, etc.).
The CSF tap test, sometimes lumbar tap test or Miller Fisher Test, is a medical test that is used to decide whether shunting of cerebrospinal fluid (CSF) would be helpful in a patient with suspected normal pressure hydrocephalus (NPH).
Treatment includes a healthy diet, salt restriction, and exercise. [2] The medication acetazolamide may also be used along with the above measures. [2] A small percentage of people may require surgery to relieve the pressure. [2] About 2 per 100,000 people are newly affected per year. [4] The condition most commonly affects women aged 20–50. [2]
The treatment of choice in NPH is ventriculoperitoneal shunt surgery (VPS). This treatment needs a VP shunt, which is a catheter with a valve aiming at implementing a one-way outflow of the excessive amount of CSF from the ventricles. It is obligatory to have patency control because of some possible complications such as infections and obstruction.
Low-pressure hydrocephalus (LPH) is a condition whereby ventricles are enlarged and the individual experiences severe dementia, inability to walk, and incontinence – despite very low intracranial pressure (ICP). [1] Low pressure hydrocephalus appears to be a more acute form of normal pressure hydrocephalus. If not diagnosed in a timely ...
Increased volume of the ventricles will result in higher pressure within the ventricles, and cause higher pressure in the cortex from it being pushed into the skull. A person may have aqueductal stenosis for years without any symptoms, and a head trauma, hemorrhage, or infection could suddenly invoke those symptoms and worsen the blockage. [4]
Symptoms are frequently accompanied by visual disturbances such as gaze paresis, reduced vision, and dizziness. [1] Increased pressures within the skull can cause a compensatory elevation of blood pressure to maintain cerebral blood flow, which, when associated with irregular breathing and a decreased heart rate, is called the Cushing reflex. [1]