Symptoms and Signs of Normal Pressure Hydrocephalus

Medical Author:
Medically Reviewed on 3/11/2019

Doctor's Notes on Normal Pressure Hydrocephalus

Normal pressure hydrocephalus (HPH) is a condition where there is too much CFS (cerebral spinal fluid), usually in older adults, that has slowly expanded the brain’s ventricles so that they press on brain tissue but without high pressures seen in other types of hydrocephalus. Signs and symptoms gradually develop; they may include memory loss, speech difficulties, apathy, difficulties with reasoning, attention and judgement and other behavior changes. Also, unsteadiness, falls, leg weakness, difficulty initiating a first step and foot shuffling may occur. Some individuals also may have frequent urination, urine urgency and/or incontinence of urine and feces.

In most patients, the cause of NPH is never known. Associated conditions like head injury, bleeding in the brain, stroke, meningitis or brain tumors have been suggested to play a role in causation of NPH.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.