When someone over age 55 develops memory problems, it is often diagnosed as Alzheimer’s, or another type of dementia, or perhaps Parkinson’s disease, all of which are progressive and non-reversible. But families should be aware of one condition that can masquerade as any of these but if accurately diagnosed, can be treated successfully. The condition is called normal pressure hydrocephalus, or NPH, and as Jane Brody reported in the New York Times, because it is so frequently missed, no one is sure how many people have it, but estimates are up to 375,000 people in the United States.
Hydrocephalus involves a buildup of pressure inside the brain from lack of drainage of the cerebrospinal fluid that bathes and cushions the brain and spinal cord. Every person makes about two soda cans’ worth of the fluid every day, and if it is not reabsorbed into the blood stream, pressure can build and cause damage to nerves and structures inside the brain.
Typically NPH presents first with a walking disorder — the victims walk slowly with feet wide apart. It then progresses to urinary incontinence and loss of memory. These three issues are considered a “classic triad” for NPH.
If NPH is suspected, imaging of the brain will reveal one or more enlarged ventricles, the holes inside the brain that are filled with cerebrospinal fluid. The treatment is to put a tube into the ventricle to drain off the accumulated fluid and divert it into the abdomen. This surgically implanted shunt is reported to benefit 70 to 80 percent of patients with NPH. The manufacturer of a programmable shunt has a web site with more information: www.lifenph.com.