Article Text

Download PDFPDF
Idiopathic normal pressure hydrocephalus: historical context and a contemporary guide
  1. Christopher Carswell1,2
  1. 1Imperial College Healthcare NHS Trust, London, UK
  2. 2Department of Brain Sciences, Imperial College London, London, UK
  1. Correspondence to Dr Christopher Carswell, Imperial College Healthcare NHS Trust, London, UK; christophercarswell{at}nhs.net

Abstract

Idiopathic normal pressure hydrocephalus (NPH) was described in 1965 as a syndrome in which hydrocephalus develops but with a normal cerebrospinal fluid (CSF) pressure, causing shunt-responsive gait apraxia, cognitive impairment and urinary incontinence. Not all patients respond to shunting despite having the clinical syndrome with appropriate radiological features. This has led to considerable debate over subsequent decades regarding idiopathic NPH. It is now understood that asymptomatic communicating hydrocephalus can develop in many healthy older people, and that over time this can develop into a symptomatic state that sometimes responds to CSF shunting, but to a variable extent. This review looks at the historical background of NPH, the use of predictive tests, the current state of clinical evidence for the diagnosis and treatment of idiopathic NPH and the possible underlying causes, to provide a contemporary practical guide for assessing patients with the radiological features of idiopathic NPH.

  • GAIT
  • COGNITION
  • DEMENTIA
  • MOVEMENT DISORDERS

Data availability statement

Data are available upon reasonable request. Not applicable.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available upon reasonable request. Not applicable.

View Full Text

Footnotes

  • Contributors CC conceived and wrote the article.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Provenance and peer review Commissioned; externally peer reviewed by Robin Corkill, Cardiff, UK, Anthony Jesurasa, Cardiff, UK, and Cath Mummery, London, UK.

Other content recommended for you