Normal Pressure Hydrocephalus (NPH)

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NPH Treatment

Normal pressure hydrocephalus cannot always be cured. As a chronic condition, however, proper treatment can make a significant improvement in the patient's quality of life.

Medications
Currently, there are no medications to directly treat NPH.

Surgery
Shunt surgery is the most common treatment for the symptoms of normal pressure hydrocephalus. However, not all patients with NPH are suitable candidates for shunt surgery. Proper diagnostic testing for NPH is essential to determine if a patient is a suitable candidate for shunt surgery.

Shunt surgery is a surgical procedure in which a neurosurgeon implants a very thin tube that leads from the enlarged ventricle in the brain into the patient's abdomen (the peritoneal cavity). Attached to the tube is a small valve that opens when CSF pressure builds up. The tube and valve transfer the excess CSF fluid from the enlarged ventricle in the brain into the abdomen. The excess CSF is then absorbed harmlessly into the bloodstream. As part of the patient's follow-up care, the flow of CSF is monitored to see if adjustments to the valve are needed. Newer valve technology allows the neurosurgeon to adjust the valve externally, so additional surgery is not required.

Endoscopic ventriculostomy also may be performed to treat NPH. In this procedure, a hole is created in the bottom, or floor, of the ventricle so that excess CSF can drain. However, this surgery is relatively new, is less commonly used, and, at this time, is associated with greater risks.

As with any surgical procedure, it is important to discuss all possible risks and benefits with your healthcare provider beforehand, and to follow all instructions for before and after the surgery. Unusual or severe side effects following surgery should be reported to your healthcare provider immediately.

Other Therapies
In general, patients with normal pressure hydrocephalus who do not undergo shunt surgery require daily care by a family member or professional caregiver. NPH patients who are advised not to have shunt surgery may experience temporary relief through periodic lumbar punctures. Other treatments may include therapies for symptom relief.

Follow-up
Patients diagnosed and treated for NPH, with or without shunt surgery, should be under the regular care of a neurologist or neurosurgeon and should see their primary healthcare provider regularly.

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