Normal pressure hydrocephalus: symptoms, medications, etc. • hello healthy

Definition

What is normal pressure hydrocephalus?

Normal pressure hydrocephalus is a condition where cerebrospinal fluid builds up in the brain. This occurs when the fluid secretion and absorption system in the brain doesn't work properly.

In conditions of normal pressure hydrocephalus, the intraventicular in the head enlarges to accommodate extra fluid. Then this fluid presses on various parts of the brain. This condition will cause a number of symptoms. Sometimes some babies are born with this condition, while others develop over time.

How is it different from ordinary hydrocephalus?

The conditions for ordinary hydrocephalus and normal pressure hydrocephalus are generally the same. The reason is, this condition is both characterized by a buildup of fluid in the toal. Ordinary hydrocephalus, which often occurs in children, is generally congenital. Has the characteristics of an enlarged head, unusual from normal head size.

This common hydrocephalus can generally be caused by events or influences that occur during fetal development, or genetic disorders. This common hydrocephalus in children can develop at birth or at some point after the baby is born.

How common is this condition?

Normal pressure hydrocephalus is rare, the ratio can occur in 1 in 100,000 people. This condition is a type of hydrocephalus that usually occurs in older adults.

The average age of people affected by this condition is over 60 years. Normal pressure hydrocephalus generally develops slowly over time. When cerebrospinal fluid becomes blocked, fluid will slowly build up in the brain.

Signs & symptoms

What are the signs and symptoms of normal pressure hydrocephalus?

Symptoms of normal pressure hydrocephalus usually start slowly and gradually. Symptoms include:

Problems with the way of the road. Most of the patients have a slow gait, shaky legs and wide strides.
Starting to experience memory loss (dementia), in addition to the ability to think slowly, forgetful, have problems with concentration and reduced ability to focus on an subject
Incontinence is an early symptom of normal pressure hydrocephalus, you will feel the urge to urinate frequently or have sudden symptoms and then experience incontinence. Incontinence problems such as frequent urination, but some people may experience bowel incontinence.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

Symptoms of hydrocephalus in children

Children, adults, and the elderly may experience different symptoms of hydrocephalus. This is because their skulls cannot expand to accommodate the fluid buildup in the brain

The usual symptoms of hydrocephalus in children may be followed by vomiting, nausea, blurred or double vision, balance problems, poor coordination, gait disorders, urinary incontinence, slow development of the child's body, lethargy, drowsiness, irritability, or other changes.

When should I see a doctor?

Call your doctor or check with the hospital if you have any of the following symptoms:

If you start to have difficulty walking or walking
If you have problems with memory both in yourself and in your family;
Incontinence that lasts quite a long time

Symptoms in each person's body are different. Always consult a doctor to treat and find out your health condition.

Cause

What causes normal pressure hydrocephalus?

This normal pressure hydrocephalus condition is likely caused by excess fluid in the ventricles of the brain. This excess fluid can also be caused due to injury, bleeding, infection, brain tumor, or surgery on the brain.

When excess fluid builds up in the ventricles, they enlarge and press on nearby brain tissue. This extra fluid and pressure can cause brain damage.

Normal pressure hydrocephalus can result from a stroke, meningitis (infection of the lining of the brain tissue), or a brain tumor. However, most of the conditions of this enlargement of the head often go unnoticed. In most cases, doctors do not yet know the reasons why this situation can lead to disease.

Risk factors

What increases my risk for normal pressure hydrocephalus?

Certain factors increase your risk of developing normal pressure hydrocephalus, namely:

The presence of an injury or tumor in the brain or spinal cord.
The presence of a central nervous system infection, such as meningitis due to bacteria or goiter.
There is bleeding in the brain caused by a stroke or head injury.
There are other brain injuries.

There are no risk factors that don't mean you can't get this disease. These markings are for reference only. You should consult a specialist for more details.

Medicines & Medicines

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are my treatment options?

There is currently no drug therapy for this disease. Treatment is usually done with surgery and treated with certain therapies. For surgery problems, in short, the doctor will place a catheter from the brain to drain the cerebrospinal fluid in the brain.

Later a shunt (flexible tube) will be placed into the ventricular system of the brain which diverts the flow of cerebrospinal fluid (CSF) to other areas of the body, most commonly the abdominal cavity, where it can be absorbed.

Then, there will be a valve on the shunt to maintain the CSF at a normal level and pressure in the ventricles. This method allows the ventricles to return to normal size.

With ETV operation

To treat normal pressure hydrocephalus, your doctor will also perform a surgical procedure called endoscopic third ventriculostomy (ETV). This surgical operation can also be considered as an alternative to the post shunt method in people with normal pressure hydrocephalus.

In this surgical process, the neurosurgeon uses a special endoscope to create an alternative cerebrospinal fluid pathway that can bypass obstructions in the brain fluid ducts.

Determination of stenosis of water channels can be done via MRI. Also, keep in mind, however, that the success of this ETV method varies. Some need to be done shunt surgery some are not.

Cognitive therapy

Cognitive therapy is therapy that will be performed depending on the type of symptoms, your condition, and whether cognitive therapy needs to be done. Cognitive therapy will be carried out with the help of exercises and tools that can help, stimulate and strengthen your mind and body.

In this cognitive therapy session, you will be trained by memorizing simple flash card pictures. In addition, the therapy trainer will train you to repeat a series of four, five or six pictures in succession.

In addition, in this therapy session you will also be trained to see complex landscape images and be challenged to be able to answer questions about these images.

Normal pressure hydrocephalus therapy will also be done by reading a one-page newspaper article and then testing you to make a summary of the facts contained in the article. At first, you may be able to summarize just a few facts, but as you practice and succeed your memory strength can grow quite well.

The therapist may also ask you to discuss any problems you have had since your last visit. Not only discussion, the therapist will offer strategies to avoid and prevent low levels of solving your problems.

Therapists will also use advanced technology such as mobile calendars or computer calendars as reminders. Its function as a tool to remind you of appointments or tasks. It is hoped that this method can become a routine practice to check activities and routines every morning, afternoon and evening.

What tests can be done to diagnose normal pressure hydrocephalus?

Diagnosis can be difficult to check if normal pressure hydrocephalus disease does not have specific symptoms as can be found in diseases such as Parkinson's disease, Alzheimer's disease, and other memory disorders.

Therefore, it is likely that the doctor will use such a method computed tomography (CT) or magnetic resonance imaging (MRI). Both methods can help doctors diagnose this condition.

In some cases, the doctor will perform a waist function test. Its function is to check the balance level of the body which will usually be affected due to normal pressure hydrocephalus.

Risks and Complications

What are the risks of complications from normal pressure hydrocephalus treatment?

1. The shunt is damaged

At the time of placing the shunt in the brain, there is a risk of damage to the shunt. The risk is partial or complete blockage of the shunt, causing the shunt to function intermittently and sometimes malfunction.

When a blockage occurs, cerebrospinal fluid (CSF) builds up and can make normal-pressure hydrocephalus symptoms worse. There is also a risk of blockage in blood cells, tissue, or bacteria due to a damaged shunt.

In addition, the ventricular catheter (the part of the tubing that is placed in the brain) and the distal part of the catheter (the tubing that drains fluid to another part of the body) can become blocked by tissue from the choroid or ventricular plexus.

The distal part of the catheter is more often blocked in adults when the shunt in the brain is damaged. Actually, shunts for hydrocephalus conditions in the brain can last a long time. However, the components can be detached or cracked due to wear or as the seirin gets older. In fact, sometimes the shunt in the brain can be detached from where it was originally placed.

2. Infection of the shunt

Shunt infections are usually caused by the presence of a person's bacterial organisms. This is not caused by transmission from other people, huh. The most common bacterial infection is due to S.taphylococcus Epidermidis. These bacteria are usually found on the surface of a person's skin, in sweat glands and in hair follicles deep within the skin.

This type of infection is most likely seen one to three months after the shunt surgery is placed. However, infection since this shunt operation can occur up to six months afterward.

People with a ventriculoperitoneal shunt (VP) condition may also be at risk for secondary shunt infection. Patients treated with ventriculoatrial (VA) shunts can develop generalized infections, which can be fatal if left untreated.

3. Subdural hematoma

Subdural hematoma is a blood clot which is a serious complication. This subdural hematoma can occur after shunt insertion. The risk of a subdural hematoma in people with normal pressure hydrocephalus and shunts is about five to ten percent.

Since most shunts drain cerebrospinal fluid from the center of the brain or ventricles, this can also cause the surface of the brain to withdraw from the skull. The surface of the brain can also stretch and tear blood vessels from the scalp to the surface of the brain.

This is what is sometimes seen on CT scans as the fluid space between the brain and skull called the hygroma. Although a hygroma may not have certain symptoms, it can increase the risk of a hematoma.

Home remedies

What are some lifestyle changes or home remedies that can be used to treat normal pressure hydrocephalus?

Once diagnosed and diagnosed with normal pressure hydrocephalus, the affected person and family should be aware that this condition poses a risk to cognitive and physical development.

But it's good not to worry, many patients diagnosed with this disorder can return to normal activities after receiving rehabilitation therapy and training to live a normal life, albeit with a few limitations.

Later, doctors and nurses will give you advice, which therapy is the best. This therapy will also be adjusted to the age and symptoms of the disease that attacks.

Symptoms of normal pressure hydrocephalus usually get worse over time if the condition is not treated. If you have normal pressure hydrocephalus, you should regularly see a neurologist or neurosurgeon. These visits allow your doctor to monitor your symptoms. Symptom changes may require adjustments in treatment.

Here are lifestyle and home remedies that can help you deal with this condition: