Normal Pressure Hydrocephalus (NPH)

Your brain is surrounded by a clear liquid called cerebrospinal fluid. This fluid circulates around the brain’s four cavities – or ventricles – to cushion and protect the brain, remove waste products and supply nutrients. Normal pressure hydrocephalus (NPH) occurs when cerebrospinal fluid doesn’t drain properly out of the ventricles. The ventricles expand and put pressure on the brain, which can cause problems with key neurological functions.



NPH occurs most often in older adults, or as the result of a traumatic injury or illness. Its negative effect on cognition and movement often mimics other conditions such as Alzheimer’s or Parkinson’s disease. Without the right diagnosis, these symptoms of normal pressure hydrocephalus can mistakenly be attributed to the aging process:

  • Diminished memory, problem-solving and other cognitive processes
  • Difficulty walking, with balance or other movement problems 
  • Incontinence or loss of bowel control


Identifying the source of your symptoms as early as possible will give you the best chance of an optimal recovery. To make a normal pressure hydrocephalus diagnosis, your doctor will ask about your symptoms and may recommend a variety of tests, including:

  • An MRI 
  • A CT scan 
  • Lumbar puncture (also known as a spinal tap)
  • Intracranial pressure monitoring
  • A variety of neurological and psychological tests to rule out other conditions

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Treatment Options

If you are diagnosed with normal pressure hydrocephalus, you and your neurological team will decide on a treatment tailored to your needs. In most cases, NPH treatment requires a shunt to be surgically placed in your brain to drain the excess cerebrospinal fluid.

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