Normal Pressure Hydrocephalus: Risks and Care

Normal Pressure Hydrocephalus

At The Brielle at Seaview, we offer a wide range of supportive care accommodations for individuals who struggle with a wide range of conditions, including normal pressure hydrocephalus and dementia. Our team is here to support you with a depth of thoughtfully designed amenities and a warm, welcoming environment.

Normal pressure hydrocephalus Is one of the lesser known conditions that affect people over 60. Yet, it is very common. The Hydrocephalus Association states that about 700,000 Americans live with this condition right now, but only a small number of them know about it. This disorder is one of the most common to remain undiagnosed – as well as untreated. The organization notes that an estimated 80 percent of people who have it do not know it.

Here are a few more statistics from the Hydrocephalus Association:

An estimated 5.2 million people are diagnosed with dementia, but about 5 percent of them are likely to have Normal Pressure Hydrocephalus instead. Keep in mind, this condition is treatable whereas dementia is not.
It’s estimated that 180,000 American veterans may have this condition without knowing it.
While this condition is treatable to some degree, there is no cure. More research could unlock opportunities to reach that point, however.

What Is Normal Pressure Hydrocephalus?

What makes normal pressure hydrocephalus so difficult to diagnose and treat is that many of the symptoms of this condition are similar to Parkinson’s disease and Alzheimer’s disease. It is a condition often misdiagnosed as dementia.

Normal pressure hydrocephalus is caused by a buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. The ventricles are the open spaces or cavities located in the brain. This clear fluid is meant to circulate around the spinal cord and the brain to protect these sensitive areas from damage when a person moves or is bumped.

In those who have normal pressure hydrocephalus, there is an excess buildup of cerebrospinal fluid– outside the normal range. This puts pressure on the brain. In these individuals, the body does not properly drain or absorb this fluid properly. Over time, that build-up can lead to damage to the brain.

One key difference to know about normal pressure hydrocephalus is that, unlike other types of hydrocephalus, this form does not change the pressure within the ventricles. This condition is most common in people over the age of 60.

Symptoms of Normal Pressure Hydrocephalus

Normal pressure hydrocephalus symptoms make this condition even more difficult to address. The signs of normal pressure hydrocephalus are similar to what would be seen when a person begins to develop dementia. They commonly include:

Changes to Walking

A person with this condition may develop changes in their ability to walk normally. For example, they may struggle to pick their feet off the ground. They may feel as though their feet are very heavy or simply stuck to the ground. This often leads to shuffling – when a person can barely pick up their feet at all. Most often, stairs and curbs become hard to manage. Some people are at a higher risk of falling because of this difficulty.

Bladder Control Problems

Another key concern is the development of incontinence. The body cannot hold urine as it should. This may lead to the need to urinate frequently, and it may also lead to changes in the way they feel. They may feel as though they need to urinate immediately, but they cannot. Others may no longer feel the need to urinate before it occurs.

Dementia

Normal pressure hydrocephalus can cause dementia in many people. This condition develops as a result of the CSF buildup. It leads to common dementia signs such as:

Trouble paying attention and focusing on tasks
Difficulty with memory, often forgetting things from one minute to the next
Lack of interest in things they used to love to do
Confusion, even during simple tasks
Extreme mood changes

Dementia is often thought to be the primary cause of these symptoms when normal pressure hydrocephalus is truly the root of the problem.

Stages of the Disease

Because normal pressure hydrocephalus is one of the causes of progressive dementia, a person’s condition may worsen over time, indicating a worsening of the effects of the buildup of CSF. There are three common stages that occur. The first begins with progressive cognitive impairment. Over time, gait and balance difficulties occur. Incontinence also develops.

The symptoms will continue to worsen over time. The length of time this takes and the severity of the symptoms ranges widely from one person to the next. Early treatment of this condition can significantly impact the severity of symptoms, improving outcomes and lifespan. However, those who have had symptoms for years without treatment can still see benefits, including improved cognitive function and longer life.

Progression of the Disease

The progression of this disease depends on many factors. For those who have early intervention, symptoms can remain mild and controlled by shunt therapy. For individual who do not receive care, the symptoms can worsen, with dementia occurring at more profound levels as more brain tissue is damaged from this condition.

Most often, this condition will worsen if left untreated. Some individuals may see some improvements over time, but these are often limited and temporary. Shunt therapy can significantly improve outcomes in some individuals.

Without any treatment, the condition may progress to more complex forms of dementia. Over time, this may lead to symptoms that require the patient to receive complex care. Over time, normal pressure hydrocephalus can cause death when brain tissue becomes significantly damaged.

Causes and Risk Factors of Normal Pressure Hydrocephalus

It’s not fully understood what causes normal pressure hydrocephalus. The cause of the buildup of the CSF remains unknown. There is limited research suggesting that it is brought on by some type of bleeding around the brain. This may occur, for example, after a stroke. It may also occur if there is a head injury. There are also indications that those who develop meningitis are more likely to develop this condition as well. In other cases, there is no known cause.

Diagnosis of Normal Pressure Hydrocephalus

To diagnose normal pressure hydrocephalus, the doctors will examine a person’s symptoms and review their medical history. Any lack of this information can make it hard to get a proper diagnosis. In addition, doctors will also use a full battery of tests to understand what is occurring. Anyone experiencing symptoms of normal pressure hydrocephalus or dementia should be screened for this condition by requesting an exam from their doctor. Do not put off getting this type of help.

Potential tests for normal pressure hydrocephalus include:

Imaging tests, like an MRI and CT scan, will determine if the ventricles are enlarged in the brain.
A cerebrospinal fluid test is a type of spinal tap that is done to extract a small amount of CSF. This allows for symptoms to improve over a period of time, which can be an indication of normal pressure hydrocephalus.
Neuropsychological testing can determine if there are impairments to the brain, including concentration-related changes, memory loss, or problem-solving challenges.
Gait testing involves a doctor watching you walk through a timed test. This will help to show the individuation of changes.

This information may help doctors better understand if you have this condition or another form of dementia. It also helps to determine the best type of treatment.

Treatment for Normal Pressure Hydrocephalus

Because there’s no cure for this condition, treatment for normal pressure hydrocephalus is designed to reduce symptoms. Many of those symptoms can be effectively managed through surgical procedures. The goal is to place a shunt in the brain, which allows for excessive CSF to drain from the brain into the lower part of the abdomen. This shunt is placed into one of the ventricles where it collects CSF, which moves through the tube that is tunneled under the skin.

As the fluid drains off the brain, symptoms will lessen significantly. There are some risks to this procedure. For example, in some individual, infection and excessive bleeding can occur during the procedure. Most often, these complications are minor and the benefits are numerous.

Care for Those with Normal Pressure Hydrocephalus

As normal pressure hydrocephalus advances, a person will develop more dementia symptoms. This means his or her ability to reason, make decisions and communicate will likely start to falter. Over time, this can mean that it is no longer safe for them to remain at home and on their own. Because normal pressure hydrocephalus damages brain tissue, it can affect communication and memory. Over time, speech and cognition may fail.

As a person’s needs change, dementia treatment becomes necessary. Those who receive treatment may find symptom relief, which means a lower level of care may be needed during that time. For those without treatment or effective treatment, it is likely that they will need dementia care.

In these situations, a supportive living environment can create a big difference in quality of life – as well as safety. Dementia care provides a person’s medical and personal needs in a safe environment. It often includes working closely with a person to ensure they are eating and taking medications as they should. Over time, many people with normal pressure hydrocephalus develop end-stage symptoms in which they may face organ failure. Having a supportive environment capable of meeting those needs is essential.

For many individuals with normal pressure hydrocephalus, the first step is therapy. Depending on the outcomes of therapy, it may become necessary to seek out more advanced memory care in a setting similar to the memory care offerings at The Brielle at Seaview.

Memory Care at The Brielle

At The Brielle, we offer compassionate memory care, offering individualized levels of support, depending on residents’ needs. To learn more about our community, download a free brochure or call 929-256-3005. We look forward to telling you more about what makes our community so special.