Normal Pressure Hydrocephalus

Normal-pressure hydrocephalus (NPH) is when the brain collects too much cerebrospinal fluid. Trouble walking, poor balance, and mood changes indicate normal pressure hydrocephalus. In addition, patients with advanced NPH who are not treated may develop seizures that worsen with time.

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My hypertensive father has involuntary bowel movements and cannot walk or hold things. Why?

Query: Hello doctor, My father, age 86, complained of being unable to walk, grasp, and hold things, involuntary bowel movements, and hypertension. Kindly help.  Read Full »

Dr. Mahmoud Ahmed Abdelrahman Abouibrahim

Answer: Hi, Welcome to I understand your concern. IIncomplete speech, muscle weakness, and involuntary bowel motion are all signs of neurological issues, most probably either stroke or normal pressure hydrocephalus (which cause a triad of dementia, abnormal walking, and urinary incontinence)...  Read Full »

Which is a better treatment for NPH, shunt surgery or CSF drainage?

Query: Hello doctor, My 76 year old¬†mother was recently diagnosed with normal pressure hydrocephalus. She is having trouble walking. She can walk only three to four steps at a time. She has been having this difficulty since a month now. She is currently not on any medication for this or for any other issu...  Read Full »

Dr. Chandan Mohanty

Answer: Hello, Welcome to I am sorry to hear about your mother. I have seen her MRI reports (attachment removed to protect patient identity). Going for lumbar puncture (LP) drainage, and then checking for a clinical improvement, before a shunt, has a better chance of determining the overal...  Read Full »

My father is not able to walk properly. Should we get a CT scan?

Query: Hi doctor, My father is not able to walk properly. His x-ray is fine. I guess it as some brain issue. Shall I go with CT scan? Kindly suggest.  Read Full »

Dr. Rajyaguru

Answer: Hi, Welcome to If patient not able to walk properly, then there are three most common possibilities. He has problem in the brain. He has problem in the spine. He has problem in peripheral nerves. If he has brain problem, then he might have a stroke or NPH (normal pressure hydrocephalus)...  Read Full »

Is surgery mandatory for normal pressure hydrocephalus in a long term diabetic?

Query: Hello doctor, My mother is 70 years old and has long diabetes (almost 40 years). For the last 20 years, she have a memory problem. She fell two times almost eight years ago. After that she have walking difficulty, for the last five years, she also have a problem controlling urine also. These proble...  Read Full »

Dr. Aida Abaz Quka

Answer: Hello, Welcome to I recommend trying Furosemide 40 mg twice daily and Acetazolamide 250 mg twice daily. She should start these drugs gradually at a low dose and increase gradually the dose. These drugs will help reduce brain fluid. But, if this is not normal pressure hydrocephalus an...  Read Full »

Could you please explain MRI brain and CSF studies related to NPH?

Query: Hello doctor,Can you please give the diagnosis of the uploaded MRI brain and CSF studies with a detailed report? Please advise on the action plan as to how to get the CSF findings treated. The MRI report is enclosed. Does the enclosed report co-relate with your findings? The MRI report CSF studies r...  Read Full »

Dr. Vivek Chail

Answer: Hi, Welcome back to The findings in the report and the images are matching and acceptable (attachment removed to protect patient identity). The term NPH is usually applied in cases where there is abnormal CSF hyperdynamic circulation with gait problems or without gait problems if inco...  Read Full »

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