One of the questions that often comes up when looking into the reversible causes of dementia has got to be “is normal pressure hydrocephalus reversible?”
Before answering this query, it is important to discuss what normal pressure hydrocephalus (NHP) is.
What is Normal Pressure Hydrocephalus
The brain has chambers that are known as ventricles. These ventricles usually contain a fluid called cerebrospinal fluid (CSF) which protects and cushions the spinal cord and the brain.
It is also responsible for supplying them with nutrients and eliminating some waste products. The body typically makes enough CSF that it absorbs daily.
However, there are times when too much of the fluid builds up in the ventricles leading to NPH.
This can result in brain damage because the extra fluid can cause expansion of the ventricles which puts pressure on the brain tissues.
NPH mostly affects the parts of the brain that control the bladder, legs, and mental cognitive processes like reasoning, memory, speaking, and problem-solving.
Even though NPH can affect anyone, it is common among seniors who are in their 60s and 70s.
Appropriately 700,000 Americans are living with NPH according to Hydrocephalus Association. It is also known as “treatable dementia.”
This is because it is one of the dementia causes that can be reversed or controlled with treatment.
Causes of Normal Pressure Hydrocephalus
Several factors contribute to excess fluid build-up in the brain ventricles and these may include:
- Brain surgery
- Infection
- Head injuries
- Bleeding around the brain
- Brain tumors
- Stroke
- Worth noting is that some people will develop NPH even in the absence of the factors above
Symptoms of Normal Pressure Hydrocephalus
Examples of NPH warning signs include:
- Confusion
- Mood Changes
- Apathy
- Loss of bladder or bowel control
- Difficulties thinking
- Depression
- Challenges with responding to questions
- Speech problems
- Nausea
- Headache
- Problems with vision
- Mild dementia that may involve loss in interest in day to day activities, challenges completing routine tasks as well as short-term memory loss and forgetfulness
- Having trouble walking, falling, changes in the way a person walks, poor balance, and getting stuck or freezing when a person wants to walk
Diagnosing NPH
It is usually challenging to diagnose normal pressure hydrocephalus because its symptoms are similar to those of other diseases such as Parkinson’s disease, Alzheimer’s disease, and Creutzfeldt-Jakob disease.
Many cases go unnoticed because the disorder is usually misdiagnosed.
This means that it often goes untreated. Doctors may use several tests to rule out other conditions and diagnose NPH such as:
- Brain scans (MRI or CT)
- Cisternography: this is a test that highlights the absorption of CSF
- Intracranial pressure monitoring: this is a diagnostic test that helps medics determine if there is low or high CSF pressure causing symptoms.
- A Lumbar catheter or spinal tap: this is a procedure that measures CSF pressure. Doctors also use this to remove some of the fluid located close to the spinal cord for analysis to help them spot any abnormalities that may direct them to the problem
- Medical interviews where doctors ask a person about the symptoms they are experiencing, past and current mental and medical problems, medications a person is taking, family medical problems, habits and lifestyle as well as travel and work experiences.
- Detailed physical exams that may include testing mental status, neuropsychological tests, and lab tests that help to rule out other medical conditions with similar symptoms.
Treating NPH
You will be happy to learn that normal pressure hydrocephalus is reversible.
In most cases persons will NPH will go through surgery so that medics can place a shunt or tube in the brain to drain off any surplus fluid.
Medics will insert the shunt into a ventricle and then pass it under the skin from a person’s head to their abdomen through the neck and chest.
This way, the excess fluid will flow from the brain into the abdomen where the body will absorb it.
At this point, the ventricles in the brain can go back to their original size.
The shunt can remain in position as long as the brain has too much CSF.
Regular follow-ups by a professional physician are essential because it helps to identify if there are any subtle changes that can show if there is a problem with the shunt.
When implanted properly, the shunt is usually not obvious to other persons and it remains in place for an indefinite period.
Most people will enjoy full recovery after treatment and continue to enjoy a good, quality life.
However, not everyone will benefit from implanting a shunt because the method does not work for a small percentage of individuals.
Although normal pressure hydrocephalus is reversible, its symptoms will become worse when it is left untreated.
It is advisable to get an early diagnosis and prompt treatment because this may increase the chances of good results.
Currently, no other medical treatment or drug has been known to help reverse normal pressure hydrocephalus.
