User:Mr. Ibrahem/Normal pressure hydrocephalus

Normal-pressure hydrocephalus (NPH) is build up of cerebrospinal fluid (CSF) in the ventricles, with near normal cerebrospinal fluid pressure. Symptoms classically include urinary incontinence, dementia, and trouble walking. The trouble walking often involves shuffling or a wide-based gait. Urinary problems may begin as frequent urination. Without treatment, symptoms worsen over time.

While the cause is frequently unknown, it may also occur as a result of a subarachnoid hemorrhage, head trauma, prior infection, tumor, or complications of surgery. The underlying mechanism is believed to involves insufficient absorption of CSF by the arachnoid granulations. It is a type of communicating hydrocephalus. The diagnosis is suspected based on symptom and may be further support by medical imaging and improvement of symptoms after lumbar puncture to drain CSF. Conditions that may present similarly include Parkinson and Alzheimer disease.

Treatment is by surgery to place a ventriculoperitoneal shunt to drain excess CSF into the abdomen to be absorbed by the lining. In those who are unable to have surgery, repeated drainage by lumbar puncture and acetazolamide may be an option. The probability of improvement following surgery is 80%.

NPH most commonly occurs in the elderly. One study found that it affects about 0.2% of those in their 70s and 5.9% of those over 80 years old. Males and females are affected with similar frequency. It is though to represent about 6% of cases of dementia. The disease was first described by Salomón Hakim and Adams in 1965.