If you’re experiencing memory problems, walking difficulties, or bladder issues, it’s natural to wonder: Could this be normal pressure hydrocephalus (NPH)<\/a>? It\u2019s also natural to wonder if you have NPH if you\u2019ve had hydrocephalus<\/a> your entire life and you feel your pressure is normal now because you\u2019re treated.<\/p>\n Before assuming that\u2019s what\u2019s going on, it\u2019s important to understand what NPH is and who it actually affects.<\/p>\n Hydrocephalus<\/strong> is the blanket term for a condition where excess cerebrospinal fluid (CSF) builds up in the brain\u2019s ventricles, which can cause pressure and lead to a wide range of symptoms depending on the type, cause, and age of onset. One type of hydrocephalus is NPH.<\/strong><\/p>\n Normal pressure hydrocephalus (NPH) is a buildup of cerebrospinal fluid (CSF) that causes the ventricles to enlarge. Although pressures may fluctuate and a single measurement may appear normal, diagnosis is based on a combination of clinical symptoms, imaging findings, and CSF-removal testing.<\/p>\n iNPH is predominantly a disorder of adults over 60. In younger adults, NPH-like syndromes are uncommon and usually secondary to another cause (e.g., hemorrhage, infection, tumor).<\/p>\n If you’re under 60 or have been living with hydrocephalus your entire life, it’s much more likely that you have a different type of hydrocephalus, and knowing which one can give you confidence in being an advocate for yourself.<\/p>\n NPH is typically identified by three hallmark symptoms, though they may not appear all at once or with the same severity:<\/p>\n These symptoms can resemble those of other age-related conditions like Alzheimer\u2019s<\/a> or Parkinson\u2019s<\/a>. But unlike those, NPH may improve with the placement of a shunt<\/a>.<\/p>\n To learn more about normal pressure hydrocephalus (NPH) vs Alzheimer’s and Parkinson’s, click here<\/a>.<\/p>\n Doctors working with the adult hydrocephalus population are now beginning to classify forms of adult hydrocephalus, thanks to the research of the Adult Hydrocephalus Clinical Research Network (AHCRN)<\/a>. If you\u2019re younger than 60 and dealing with hydrocephalus symptoms, you may have one of the following:<\/p>\n Communicating vs. Non-Communicating Hydrocephalus<\/strong><\/a><\/p>\n We see a lot of adults who have a normal head size but otherwise appear to have had asymptomatic hydrocephalus for possibly decades. We don’t really know the cause of why it manifested after the skull sutures have closed after\/around age 2, but it presents similar to pure congenital, at-birth cases. We don’t really consider it acquired unless we can identify the cause.<\/p>\n People with asymptomatic or decompensated congenital hydrocephalus don\u2019t experience symptoms until adulthood. You may have been symptom-free for years \u2014 and then start noticing:<\/p>\n These symptoms overlap with those seen in NPH, which can cause confusion. But in most cases, it\u2019s not NPH \u2014 it\u2019s a shift in your existing hydrocephalus. And for some of you, that may be hydrocephalus that you didn’t even know you have.<\/p>\n Either way, NPH is extremely unlikely if you\u2019re under 60. The key is getting a comprehensive evaluation to understand your true history with the condition.<\/p>\n Use this quick guide to better understand where your diagnosis might fall. \u2192 Yes<\/strong><\/span> \u2192 No<\/strong><\/span> \u2192 Yes<\/strong><\/span> If you\u2019ve been told you might have NPH or your diagnosis feels unclear, here are a few steps to take:<\/p>\n Ask your doctor:<\/strong><\/p>\n For a list of questions to ask your doctor, click here.<\/a><\/p>\n Check or request your records:<\/strong><\/p>\n Get a second opinion:<\/strong> Find Support and Get Answers<\/strong><\/p>\n You don\u2019t have to figure this out alone. If you’re feeling unsure or overwhelmed, we\u2019re here to help:<\/p>\n It\u2019s important to know the type and cause of your hydrocephalus so that you can be an informed advocate for your care. As clinical researchers continue to define adult hydrocephalus, we encourage you to stay involved and connected to help us understand adult hydrocephalus and develop support and educational resources for you. One way to help is by joining our patient registry \u2013 HAPPIER. Find out more.\u00a0<\/a><\/p>\n Information you can trust! This article was produced by the Hydrocephalus Association, copyright 2024. We would like to thank\u00a0Abhay Moghekar, MBBS,\u00a0for his valuable contribution and expert input.<\/i>
\nKnow the Difference between Hydrocephalus and NPH<\/h2>\n
\nWhat Is Normal Pressure Hydrocephalus (NPH)?<\/h2>\n
\nWhat Are the Symptoms of NPH?<\/h2>\n
\n
\nWhat Type of Hydrocephalus Do I Have If I\u2019m Under 60 or Have Been Living With it My Entire Life?<\/h2>\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\nWhy It Might Seem Like NPH<\/h2>\n
\n
\nWhat Type of Hydrocephalus Do I Have?<\/h2>\n
\nAlways consult your doctor to confirm.<\/p>\nStep 1: Are you over 60 years old?<\/h3>\n
\n\u2022 Do you have walking problems, cognitive changes, and\/or bladder symptoms?
\n\u2192 If yes:<\/strong> <\/span>Ask your doctor about normal pressure hydrocephalus (NPH)
\n\u2003\u2192 If no:<\/span><\/strong> Your symptoms may be due to another condition or type of hydrocephalus<\/p>\n
\n\u2022 Continue below<\/p>\nStep 2: Are you under 60 years old?<\/h3>\n
\n\u2022 Did your hydrocephalus begin in childhood, or after a brain bleed, infection, tumor, or injury?
\n\u2192 If yes:<\/strong><\/span> You likely have congenital or acquired hydrocephalus
\n\u2003\u2192 If not sure:<\/span><\/strong> Ask your doctor for clarification<\/p>\n
\nWhat Should You Do If You\u2019re Not Sure?<\/h2>\n
\n
\n
\nEspecially if your symptoms are changing or your diagnosis has never been well explained. A neurologist or neurosurgeon experienced in hydrocephalus can help clarify things. To learn more about second opinions, click here.<\/a><\/p>\n\n
\nWhat This Means for You<\/h2>\n
\n
\n
\nThis article is designed to provide helpful information on the subjects discussed. It is not intended as a substitute for treatment advice from a medical professional. For diagnosis or treatment of any medical condition, consult your doctor.<\/i><\/em><\/p>\n\r\n Was this resource helpful?<\/h3>\r\n <\/div>\r\n