Normotensive hydrocephalus, or HPN, is a situation characterized by the accumulation of cerebrospinal fluid (CSF) in the brain and enlargement of the cerebral ventricles by excess fluid, which can lead to the onset of three characteristic symptoms, which are difficulty walking. , urinary incontinence and loss of cognitive functions.
HPN is more common in people over 65, although it can occur at any age and is completely reversible, meaning it is curable as long as it is quickly identified and treated. In most cases, treatment is done by draining the accumulated CSF and redirecting it to another part of the body to be reabsorbed.
- Despite excess fluid in the intracranial cavity.
- There is no increased pressure.
- But the development of three typical symptoms.
- Known as the HPN triad: difficulty walking.
- Urinary incontinence and progressive memory loss and cognitive functions.
- These symptoms may appear together or separately.
- Not in a specific order and gradually.
- Other signs and symptoms indicative of NPH include:.
Symptoms of NPH may also be considered typical manifestations of old age or signs of dementia, Alzheimer’s, Parkinson’s or depression, for example. Therefore, it is important that when the signs and symptoms of normotensive hydrocephalus are identified, the person is referred to the neurologist for differential testing and therefore treatment is initiated.
Diagnosis of HPN should be made by your family doctor or neurologist using certain tests such as CT or MRI to visualize the brain, identify fluid build-up hotspots, and enlarged brain ventricles.
In addition, the Tap-Test, which is an exam used to check if the patient would have a positive development with surgical treatment, may be performed. This test involves testing to assess the patient’s symptoms, especially changes in gait, and a lumbar puncture is performed to remove excess fluid. At three hours of the puncture, symptom tests are re-tested and if it turns out that at 3 hours there is no worsening of symptoms, it is a sign that the ventricles have not been completely filled and that the person has a good chance of having positive results for surgical treatment.
Normotensive hydrocephalus can be classified as idiopathic, which is unknown why there has been an enlarged ventricle by excessive production of CSF, or secondary, that is, when the disease occurs as a result of another situation.
For example, secondary HPN can occur as a result of changes in fetal development, traumatic brain damage, strokes, and nervous system infections, such as bacterial meningitis and mumps, for example.
Treatment of normal pressure hydrocephalus aims to reduce symptoms of the disease by draining the accumulated CSF from the ventricles to another part of the body to be reabsorbed. Therefore, it is possible to reduce the ventricle to its normal size and relieve symptoms.
In addition, during the procedure, your doctor may also circulate a medicine in your brain to regulate the amount of CSF produced, thus preventing the buildup from reproducing. Understand how hydrocephalus is treated.