Normal Pressure Hydrocephalus (NPH) is a neurological condition characterized by the accumulation of cerebrospinal fluid (CSF) in the brain’s ventricles, causing them to enlarge without significantly increasing intracranial pressure. NPH often affects older adults and presents with a classic triad of symptoms: gait disturbances, urinary incontinence, and cognitive decline. The exact cause may be idiopathic or secondary to brain injury, infection, or hemorrhage. Early recognition is crucial, as untreated NPH can lead to progressive neurological impairment and decreased quality of life. Timely evaluation allows neurosurgeons to plan effective interventions that improve mobility, cognition, and independence.
Diagnosis involves a detailed neurological examination along with imaging studies such as MRI or CT scans to assess ventricular enlargement. Additional tests may include lumbar puncture, CSF flow studies, and neuropsychological assessments to differentiate NPH from other causes of dementia or gait disorders. Accurate evaluation ensures appropriate treatment planning and better outcomes.
The primary treatment for NPH is cerebrospinal fluid diversion, most commonly through ventriculoperitoneal (VP) shunting or endoscopic third ventriculostomy (ETV). These procedures restore normal CSF flow, reduce ventricular size, and alleviate symptoms. Minimally invasive techniques are often preferred to reduce complications and enhance recovery.
Post-treatment recovery includes monitoring for shunt function, managing complications, and addressing residual neurological deficits. Rehabilitation focuses on gait training, balance exercises, physiotherapy, and cognitive support. Regular follow-up imaging ensures proper CSF drainage and early detection of shunt-related issues. With timely intervention and structured care, most patients experience significant improvement in mobility, bladder control, and cognitive function, leading to enhanced independence and quality of life.
Dr. Vamsi Krishna, Consultant Neurosurgeon at Yashoda Hospitals, Hitech City, Hyderabad, specializes in minimally invasive CSF diversion procedures. His expertise in VP shunt and endoscopic third ventriculostomy ensures safe, precise, and effective treatment, optimizing symptom relief and long-term neurological outcomes for patients with NPH.
