Helping You Find Lasting Relief From NPH
When you’re facing frustrating symptoms, you want answers from experts who understand the differences between conditions that often overlap. Because symptoms of normal pressure hydrocephalus (NPH) are often masked by the normal aging process, NPH is difficult to diagnose and often goes untreated. We’re here with the hope you need.
Our institute network includes a dedicated NPH program to help identify the cause of your symptoms and deliver effective treatment and relief sooner. You and your family can count on our experienced team to help you understand your condition and deliver NPH treatments that work, all with your whole-person health at the center of our focus.
Feel Hopeful With the Right NPH Expertise at Your Side
There’s hope for better treatment of this often-misdiagnosed condition. While some providers may treat NPH like any other age-related concern, that’s not how we see it. From our first conversation to your ongoing support, we’ll deliver forward-thinking and compassionate care for NPH, so you can get back to living your best life.
-
New Approaches to Diagnosis
Your path to wellness drives our innovation. Within the AdventHealth Neuroscience Institute network, we’ve developed a protocol for diagnosing and treating NPH that ensures you get the right answers.
-
Dedicated Experts to Guide You
From evaluation to follow-up care, you’ll be guided by a handpicked team that may include specialists in nursing, physical therapy, neuropsychology, internal medicine, neuroradiology and more.
-
Care That Keeps on Improving
Our team is building off the success of our accurate diagnoses and NPH treatment options — and continues to push the boundaries of how we can better care for you and your family.
A Focused Program to Better Serve You
- The Only Program of Its Kind
-
There’s hope for better treatment of this often-misdiagnosed condition. It’s what inspired us to create the only NPH program in Central Florida and one of only 10 in the U.S.
- A New Approach to Diagnosis
-
Your path to wellness drives our innovation. At the AdventHealth Neuroscience Institute network, we’ve developed a protocol for diagnosing and treating NPH that ensures you get the right answers.
- Guided, Specialized Care
-
From evaluation to follow-up care, you’ll be guided by a handpicked team that may include specialists in nursing, physical therapy, neuropsychology, internal medicine, neuroradiology and more.
- Understanding Your Treatment Options
-
Because NPH is commonly diagnosed in people over 60, its symptoms are often confused with the natural aging process. It may even be misdiagnosed as Alzheimer’s or Parkinson’s disease. But, when detected early enough, NPH can be treatable and reversible. Symptoms may include loss of urinary control, memory loss and problems walking.
There are two types of NPH:
- Idiopathic (or Primary) — Though it has no known cause, it’s characterized by a triad of symptoms: dementia, urinary incontinence and gait disturbance.
- Secondary — This type is typically associated with a head injury, an infection of the brain, hemorrhage or a tumor.
NPH is caused by an accumulation of cerebrospinal fluid (CSF) that causes the ventricles in your brain to become enlarged, sometimes without creating much intracranial pressure (ICP). Fortunately, there’s a way to remove the fluid by attaching a small, external drain to your lower back. If this temporary solution improves your symptoms, our physicians will likely recommend you have a permanent shunt implanted under your skin to continuously regulate the fluid and provide ongoing relief.
Request a Consultation With a Neurology Specialist
Whether you’re experiencing new symptoms or were recently diagnosed, the compassionate neurological care you need is close to home. Request a visit with one of our experienced neurology specialists to begin a personalized treatment plan that supports your whole health.
What to Know About Normal Pressure Hydrocephalus
- Normal Pressure Hydrocephalus 101
-
A clear liquid called cerebrospinal fluid (also abbreviated to CSF) cushions your brain and protects it from injury. Sometimes, bleeding in the brain or infection can trigger a buildup in CSF. The accumulation of cerebrospinal fluid (CSF) causes the ventricles in your brain to become enlarged, sometimes without creating much intracranial pressure (ICP). This buildup leads to normal pressure hydrocephalus, which affects your neurological functions and is difficult to diagnose. It’s sometimes confused with Parkinson’s disease or Alzheimer’s disease.
- Normal Pressure Hydrocephalus Symptoms
-
Normal pressure hydrocephalus can be hard to identify because it isn’t as common as other neurological diseases and shares many neurological symptoms with conditions often associated with aging.
The three main symptoms of normal pressure hydrocephalus are gait disturbances, urinary incontinence and cognitive impairment. These symptoms can show up as:
- Balance problems
- Confusion
- Difficulty walking
- Inability to focus
- Short-term memory loss
- Urinary frequency or urgency
We now know that patients with NPH may have one or two of these symptoms at first and are often overlooked or treated for other conditions. Patients who have been diagnosed with NPH in its earliest stages — before symptoms get worse — respond better to treatment.
- Types of Normal Pressure Hydrocephalus
-
There are two types of NPH:
- Idiopathic (or primary): Though it has no known cause, it’s characterized by a triad of symptoms: dementia, urinary incontinence and gait disturbance.
- Secondary: This type is typically associated with a head injury, an infection of the brain, hemorrhage or a tumor.
When detected early enough, NPH can be treatable and reversible.
- Diagnosing Normal Pressure Hydrocephalus
-
Diagnosing NPH can be difficult, as no one test can determine whether you suffer from the disorder. Most times, your family physician will look for one or more distinct symptoms and perform a medical history evaluation and a physical exam to see how you walk. If further testing is needed, you may be referred to a specialist for screenings, such as:
- Imaging tests, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), help doctors examine your skull and translate radiographic images to a computer screen that can reveal brain damage.
- Neuropsychological testing allows your physician to observe your problem-solving skills.
Once the physician suspects NPH, an evaluation to determine whether you may benefit from a permanent solution (shunt) is usually considered.
- Normal Pressure Hydrocephalus Treatments
-
NPH is most often treated by removing the accumulation of cerebrospinal fluid by attaching a small, external drain to your lower back. Some procedures to do this include:
External Lumbar Drainage
In this procedure, your physician will remove some of your excess cerebrospinal fluid through a hollow tube called a catheter placed into your spine. If needed, your surgeon may insert a long, thin, hollow tube called a shunt into your body to redirect cerebrospinal fluid from your brain toward your abdomen, where it can flow as a natural part of your circulatory process.
Spinal Tap
This method allows your physician to extract some of your excess cerebrospinal fluid through a needle that your physician inserts into the affected region.
Permanent Shunt
If you respond well to a drain trial, your physician will likely recommend that you have a permanent shunt implanted under your skin to continuously regulate the fluid and provide ongoing relief.
A Community of Support
A strong support system goes a long way. That’s why we’ve put together a comprehensive list of patient services. From support groups, wellness programs and a dedicated care coordinator to financial assistance tools, you always have helpful resources and compassionate people to lean on.
Dedicating All Our Expertise to Helping You Heal
Your healing is our whole focus. From clinical trials that develop new treatments to leading-edge technologies that mean a smoother recovery, we’re dedicated to raising the bar for neurological care with your whole health in mind. Explore how we’ll support you and your loved ones with the most advanced care and the utmost compassion.
Resources
From support groups and educational guides to caregiver support, financial assistance and more, we offer a range of resources to help you and your loved ones better understand and manage your condition.
Research
Innovative care starts with medical research. See how we’re developing new treatments and procedures, leading concussion and brain injury-related studies, conducting clinical trials for stroke care and more.
Technology
Explore how we use robotic technologies, precise therapies and leading-edge techniques to care for epilepsy, eliminate masses with less pain, treat brain tumors in a matter of hours and much more.
Answering Your Questions About Normal Pressure Hydrocephalus
You and your family deserve to find answers and relief. Your care team will take the time to address all your concerns about NPH — offering more detailed insights into the common questions below — to help you feel informed, comfortable and confident as you take your next step.
-
Q:Question: What are the early signs of normal pressure hydrocephalus, and how is it different from Alzheimer’s disease or Parkinson’s disease?
A:Answer:The earliest sign of normal pressure hydrocephalus is often a change in how you walk, like difficulty taking a first step (feeling like your feet are stuck) or having to shuffle to move around. Normal pressure hydrocephalus differs from Alzheimer’s and Parkinson’s in that it’s a structural disorder (caused by cerebrospinal fluid buildup) and not a degenerative disease. Unlike Alzheimer’s disease and Parkinson’s disease, normal pressure hydrocephalus is a treatable condition (symptoms often improve with shunt surgery), does not cause tremors or muscle stiffness and walking problems appear early on with the condition, as opposed to later with degenerative diseases.
-
Q:Question: Do I need to have all three classic symptoms of NPH to be diagnosed or treated?
A:Answer:No. In general, gait disturbance (difficulty walking) plus one additional symptom (either urinary incontinence or dementia) is enough for a physician to consider diagnosing and treating normal pressure hydrocephalus.
-
Q:Question: Which brain imaging findings make doctors suspect NPH?
A:Answer:An MRI or CT scan that shows enlarged ventricles in the brain (ventriculomegaly) could indicate normal pressure hydrocephalus. Doctors also look for disproportionate changes in the subarachnoid spaces of the brain and evaluate the flow of cerebrospinal fluid as they work to diagnose or rule out normal pressure hydrocephalus.
-
Q:Question: How long does it take to recover after shunt surgery, and when will I know if it is working?
A:Answer:Shunt surgery is performed in a hospital and usually requires a two- to four-day stay. Many people feel symptoms improve quickly, but it may take several weeks or months to experience the full benefits of shunt surgery.
-
Q:Question: If I improve after a tap test or lumbar drain trial, how well does that predict success with a shunt?
A:Answer:If your symptoms improve after a lumbar drain trial, it’s highly likely that you’ll respond similarly — or experience even greater symptom improvement — to permanent treatment with a shunt. Your hospital care team will make a clinical recommendation about a permanent shunt, and you’ll be referred to a neurosurgeon who can discuss the results of our test and determine your best next step.
Find Normal Pressure Hydrocephalus Care Near You
With NPH, you deserve answers, guidance and relief, and that’s what you can expect from our specialists within the AdventHealth Neuroscience Institute network. Here, you’ll find personalized treatment for this often-misunderstood condition, from an accurate diagnosis to strong follow-up care — all coordinated through a trusted national network. Explore your options for care close to home with the guidance of our dedicated team. We’ll help you find the right fit, so you’re in the best setting to get the care you need.
