Normal Pressure Hydrocephalus

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What is normal pressure hydrocephalus?

Normal pressure hydrocephalus (NPH) is an abnormal buildup of cerebrospinal fluid (CSF) in the brain's ventricles (cavities). It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way. This causes the ventricles to enlarge, putting pressure on the brain.

Normal pressure hydrocephalus can occur in people of any age, but it is most common in the elderly. It may result from:

  • A subarachnoid hemorrhage
  • Head trauma
  • Infection
  • Tumor
  • Complications of surgery

However, many people develop NPH even when none of these factors are present. In these cases, the cause of the disorder is unknown.

Symptoms of NPH include:

  • Progressive mental impairment and dementia
  • Problems with walking
  • Impaired bladder control

The person also may have a general slowing of movements or may complain that his or her feet feel "stuck." Because these symptoms are similar to those of other disorders such as Alzheimer's disease, Parkinson's disease, and Creutzfeldt-Jakob disease, the disorder is often misdiagnosed. Many cases go unrecognized and are never properly treated.

Doctors may use a variety of tests to help diagnose NPH and rule out other conditions. 

Treatment involves surgical placement of a shunt in the brain to drain excess CSF. This allows the brain ventricles to return to their normal size. Regular follow-up care by a physician is important in order to identify subtle changes that might indicate problems with the shunt.

Early diagnosis and treatment improves the chance of a good recovery. Without treatment, symptoms may worsen and cause death.

Learn About Clinical Trials
Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.

How can I or my loved one help improve care for people with normal pressure hydrocephalus?

Consider participating in a clinical trial so clinicians and scientists can learn more about NPH and related disorders. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with NPH at

Where can I find more information about normal pressure hydrocephalus?

Information may be available from the following resources:

Hydrocephalus Association


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Order publications from the NINDS Catalog
The NINDS Publication Catalog offers printed materials on neurological disorders for patients, health professionals, and the general public. All materials are free of charge, and a downloadable PDF version is also available for most publications.