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. The fluid build-up causes the ventricles to enlarge and the pressure inside the head to increase, compressing surrounding brain tissue and leading to neurological complications. Although the cause of idiopathic (also referred to as primary) NPH remains unclear, it has been associated with various co-morbidities including hypertension, diabetes mellitus, Alzheimer's disease, and hyperlipidemia.[1][2][3] Causes of secondary NPH include trauma, hemorrhage, or infection.[4] The disease presents in a classic triad of symptoms, which are memory impairment, urinary frequency, and balance problems/gait deviations (note: this diagnosis method is obsolete[5][6]). The disease was first described by Salomón Hakim and Raymond Adams in 1965.[7]
The treatment is surgical placement of a ventriculoperitoneal shunt to drain excess CSF into the lining of the abdomen where the CSF will eventually be absorbed. NPH is often misdiagnosed as other conditions including Meniere's disease (due to balance problems), Parkinson's disease (due to gait) or Alzheimer's disease (due to cognitive dysfunction).
^Pyykkö, Okko T.; Nerg, Ossi; Niskasaari, Hanna-Mari; Niskasaari, Timo; Koivisto, Anne M.; Hiltunen, Mikko; Pihlajamäki, Jussi; Rauramaa, Tuomas; Kojoukhova, Maria; Alafuzoff, Irina; Soininen, Hilkka; Jääskeläinen, Juha E.; Leinonen, Ville (April 2018). "Incidence, Comorbidities, and Mortality in Idiopathic Normal Pressure Hydrocephalus". World Neurosurgery. 112: e624–e631. doi:10.1016/j.wneu.2018.01.107. ISSN 1878-8769. PMID 29374607.
^Liew, Boon Seng; Takagi, Kiyoshi; Kato, Yoko; Duvuru, Shyam; Thanapal, Sengottuvel; Mangaleswaran, Balamurugan (2019). "Current Updates on Idiopathic Normal Pressure Hydrocephalus". Asian Journal of Neurosurgery. 14 (3): 648–656. doi:10.4103/ajns.AJNS_14_19. ISSN 1793-5482. PMC 6703007. PMID 31497081.
^Williams, Michael A.; Malm, Jan (April 2016). "Diagnosis and Treatment of Idiopathic Normal Pressure Hydrocephalus". Continuum (Minneapolis, Minn.). 22 (2 Dementia): 579–599. doi:10.1212/CON.0000000000000305. ISSN 1538-6899. PMC 5390935. PMID 27042909.
^Nakajima, Madoka; et al. (Feb 2021). "Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus". Neurologia Medico-chirurgica (Tokyo). 61 (2): 63–97. doi:10.2176/nmc.st.2020-0292. PMC 7905302. PMID 33455998.
^"Normal Pressure Hydrocephalus: a neurologist's perspective". YouTube. 2022-11-01. Retrieved 2022-08-10.
^Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH (July 1965). "Symptomatic Occult Hydrocephalus with Normal Cerebrospinal-Fluid Pressure". The New England Journal of Medicine. 273 (3): 117–26. doi:10.1056/NEJM196507152730301. PMID 14303656.
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