Normal pressure hydrocephalus

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Normal pressure hydrocephalus (NPH)

Normal pressure hydrocephalus is called “normal pressure” because despite the excess fluid, CSF pressure as measured during a spinal tap is often normal. As brain ventricles enlarge with the excess CSF, they can disrupt and damage nearby brain tissue, leading to difficulty walking, problems with thinking and reasoning, and loss of bladder control.

Normal pressure hydrocephalus can sometimes be treated with surgical insertion of a shunt, a long, thin tube that drains excess CSF from the brain to the abdomen. Surgery is most likely to help correct difficulties walking, but thinking changes and loss of bladder control are less likely to improve. Shunting doesn’t help everyone with normal pressure hydrocephalus, and there’s uncertainty about how best to identify those most likely to benefit. 

As shown below, MRI FLOWMETRY is one of the methods to diagnose NPH

MRI CSF flowmetry using the phase-contrast method is an advanced imaging parameter that can non-invasively and reliably detect NPH. Also, it can be used to follow the response to treatment following shunting and can act as a prognostic marker.