![]() In a population-based study from western Sweden, the prevalence of iNPH was estimated at 0.2% (200 out of 100,000 individuals) in the age group of 70-79 years, and 5.9% (5,900 out of 100,000 individuals) for age 80 years and older. These patients must be differentiated from patients whose ventricular enlargement is a result of shrinkage of surrounding tissue, as in Alzheimer's disease, for example. The significant difference between them is that secondary NPH affects persons of all ages, while iNPH is mainly a disease of the elderly.Īll these conditions can cause hydrocephalus but the pathological process which leads to NPH is not clear. Symptomatic (secondary) NPH - this may be secondary to:Ĭommon features of iNPH and secondary normal pressure hydrocephalus are that both are communicating types of hydrocephalus and both carry a similar prognosis.Idiopathic (primary) NPH - there is no identifiable cause (in approximately 50% of cases).There are two forms of normal pressure hydrocephalus: ![]() ![]() Pathophysiological factors including hypoperfusion, glymphatic impairment, disturbance of metabolism, astrogliosis, neuroinflammation, and blood-brain barrier disruption contribute to the formation of white and grey matter lesions, and later cause the typical symptoms. The pathogenesis of idiopathic normal pressure hydrocephalus (iNPH) is still unclear but the current expert opinion is that ventriculomegaly resulting from cerebrospinal fluid (CSF) dynamics may initiate a vicious cycle of injuries in iNPH. The three patients identified in the original series had dilation of the cerebral ventricles without an increase in CSF pressure on lumbar puncture. It was first described by Hakim and Adams in 1965. The importance of this diagnosis lies in the fact that it is a potentially reversible cause of dementia, accounting for up to 6% of dementias. Normal pressure hydrocephalus (NPH) describes the condition of ventricular dilatation in the absence of raised CSF pressure on a lumbar puncture (also known as a spinal or CSF tap), characterised by a triad of gait abnormality, urinary (usually) incontinence and dementia. What is normal pressure hydrocephalus (NPH)?
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