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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.).
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]
Intracranial hypertension (IH), also called increased ICP (IICP) or raised intracranial pressure (RICP), refers to elevated pressure in the cranium. 20–25 mmHg is the upper limit of normal at which treatment is necessary, though it is common to use 15 mmHg as the threshold for beginning treatment.
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.
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]
Ischemic hypoxia can also be created by pressure on the brain. Cerebral edema, brain hemorrhages and hydrocephalus exert pressure on brain tissue and impede their absorption of oxygen. Histotoxic hypoxia – Oxygen is present in brain tissue but cannot be metabolized by the brain tissue. Cyanide poisoning is a well-known example.
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 ...