Abstract
Normal Pressure Hydrocephalus (NPH) is a common disease among elderly patients throughout the world. NPH is frequently described as having a triad of gait disturbance, urinary dysfunction, and cognitive decline. Other neurologic diagnoses may mimic NPH, particularly Alzheimer's dementia and Parkinsonism. The pathophysiology of NPH appears related to disruption in cerebrospinal fluid (CSF) dynamics. More advanced radiological imaging measurements and techniques may aid in the diagnosis and possibly predict treatment outcomes. High-volume lumbar puncture or lumbar drainage with careful monitoring of clinical symptoms and objective physical therapy assessments may also help with NPH diagnosis and predict post-surgical outcomes. Patients meeting diagnostic criteria for NPH are then referred to a neurosurgeon for placement of a ventriculoperitoneal or lumboperitoneal shunt. Sophisticated programmable shunt can help modulate CSF drained, titrated to the patient's clinical status, and avoid complications such as a subdural hematoma from over-drainage of CSF.
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