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.
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Dementia (Loss of Memory)Dementia is the loss of reasoning, memory, and other mental abilities. Dementia may be caused by irreversible causes such as Alzheimer's disease, Parkinson's dementia, Lewy body dementia, and vascular dementia. There are also treatable causes of dementia such as infections, head injury, normal hydrocephalus, and metabolic and hormonal disorders. Early symptoms of dementia include forgetting appointments and names, losing things, difficulties performing familiar tasks (driving, cooking, household chores), personality changes, mood swings, paranoia, and suspiciousness. There are 7 types of dementia. A variety of tests (blood tests, scans, assessment of family history) may be used to diagnose dementia. Treatment may include medication and behavioral therapy.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.