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The NPH syndrome Hakim and Adams1 described is now separated into idiopathic NPH (iNPH) and secondary NPH,3 with the latter typically arising from conditions such as subarachnoid hemorrhage or infectious meningitis.
However, it is not clear why or how these conditions lead to NPH. According to the National Council on Aging (NCOA) the incidence of NPH is not entirely clear. While some experts say that approximately 75,000 people have NPH, esti-mates have ranged from …
When the clinical presentation and neuroimaging finding are consistent with NPH, the patient should have the definitive test for NPH, either a large-volume LP or an indwelling lumbar drain.
The cognitive symptoms associated with NPH are usually less severe than full-blown dementia, and are often overlooked for years or accepted as an inevitable consequence of aging. People with NPH do not usually lose language skills, but they may be less aware of their deficits than those around them, and may even deny that there are any problems.
In Normal Pressure Hydrocephalus (NPH) there is little or no increase in the pressure of the fl uid in the brain, even though the ventricles may become enlarged.
Studies have reported that NPH patients have lower levels of Aβ in the CSF compared to healthy controls, suggesting that NPH may be associated with a reduced clearance of Aβ from the brain.
More research is needed to understand the prevalence of NPH; show how the excess CSF involved in NPH causes symptoms affecting movement, thinking and bodily functions; and clarify the possible benefits and ideal targets of shunt insertion.
In the synthesis of this article, current initiatives providing perspectives for an improved management of the NPH patient, the evidence-based NPH practice guidelines and the European multicenter study on prediction of outcome in idiopathic NPH, are introduced.
Currently, there is no known nonsurgical cure for NPH. Medications that are often used to reduce excess fluid in the body have not been found to be effective in treating NPH.
NPH often goes untreated because it can resemble Alzheimer’s or Parkinson’s disease. But if diagnosed early, NPH may be treated with a shunt device that drains fluid from the ventricles and returns them to normal size.
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