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Normal pressure hydrocephalus (NPH) - Treatment

Alternative Names

Hydrocephalus - idiopathic; Hydrocephalus - adult; Hydrocephalus - communicating; Extraventricular obstructive hydrocephalus

Treatment:

The treatment of choice is surgery to place a tube called a shunt that routes the excess CSF out of the brain ventricles. This is called a ventricoperitoneal shunt.

Some patients improve a lot after this surgery, but many do not. Walking is the symptom most likely to improve. No specific symptoms or test results can accurately predict which patients are most likely to get better after surgery.

See: Dementia - homecare for information about taking care of a loved one with dementia.

Expectations (prognosis):

Without treatment, symptoms often get worse and could lead to death.

Surgical treatment improves symptoms in a percentage of patients. People with minimal symptoms have the best outcome.

Complications:

  • Complications of surgery (infection, bleeding)
  • Dementia that becomes worse over time
  • Injury from falls
  • Shortened life span

Calling your health care provider:

Call your health care provider if:

  • You or a loved one is having increasing problems with memory, walking, and urine incontinence
  • A person with NPH worsens to the point where you are unable to care for the person yourself.

Go to the emergency room or call the local emergency number (such as 911) if a sudden change in mental status occurs. This may mean that another disorder has developed.

  • Reviewed last on: 3/9/2010
  • Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Rosenberg GA. Brain edema and disorders of cerebrospinal fluid circulation. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 63.

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