NPH is usually characterized by a triad of symptoms: complaints of gait disturbance (difficulty walking), mild dementia and impaired bladder control. These symptoms may not occur all at the same time, and sometimes only one or two symptoms are present. The triad of symptoms is often associated with the aging process and a majority of the NPH population is older than 60 years. The cognitive deficits of NPH can resemble those associated with Alzheimer’s and the gait disturbances of NPH can look similar to those of Parkinson’s disease. In some cases NPH can occur in combination with these diseases. Symptoms of hydrocephalus seem to progress with time, but the rate is variable. As a general rule, the earlier the diagnosis, the better the chance for successful treatment; however some patients who have had symptoms for years may improve with treatment.
In addition to a complete medical history and physical examination, a patient might undergo a series of diagnostic procedures including Magnetic resonance imaging (MRI), a CT scan or CSF tests to predict shunt responsiveness and/or determine shunt pressure.
The only available treatment for NPH is the surgical implantation of a shunt, a device that channels CSF sway from the brain to another part of the body where it can be absorbed. After the surgery, all components of the shunt system are entirely under the skin, and nothing is exposed to the outside.