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Normal pressure hydrocephalus

Normal pressure hydrocephalus (NPH) is a type of reversible dementia which affects people aged 60 and over and can easily be mistaken for Alzheimer’s or Parkinson’s Disease. Currently it is estimated that more than 60,000 Brazilians have NPH, but most are not aware of this.

NPH is characterized by three perceptible alterations:

• alteration in gait

• urinary incontinence

• impairment of memory or behavior

The best clinical results are obtained when hydrocephalus is diagnosed and treated rapidly, resulting in the recovery of health and quality of life.

Imaging examinations, such as computed tomography scans and magnetic resonance imaging of the cranium confirm the diagnosis of this disease.

The tap test, the lumbar infusion test and the 72-hour external lumbar drainage test are examinations predictive of therapeutic success.

Once hydrocephalus has been diagnosed and with the clinical state permitting, the patient should be submitted to neurosurgery to promote recovery of the mental and motor skills, as well as bladder and bowel control.

Currently there are two neurosurgical options for treating hydrocephalus:

• VP (ventriculoperitoneal shunt) – consisting of the implantation of a valve which drains the excess intracerebral fluid, controls intracranial pressure and the dimensions of the cerebral ventricles.

• ETV (endoscopic third ventriculostomy) – is a minimally invasive procedure that consists of a perforation of the floor of the third ventricle improving the circulation of the cerebrospinal fluid.

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