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Normal Pressure Hydrocephalus (NPH)

What is Normal Pressure Hydrocephalus?

Normal pressure hydrocephalus (NPH) results from the accumulation of excessive cerebrospinal fluid (CSF) in the ventricles of the brain. CSF is produced naturally by the body and acts as a protective cushion for the brain and spinal cord. When too much CSF is produced and is not properly absorbed by the body, blockage occurs and the ventricles become enlarged, creating pressure and swelling of the brain. This swelling affects the brain’s ability to function normally.

NPH most commonly occurs in adults over the age of 60. Other risk factors for the disorder are head injuries, brain infections, and brain tumors.

Causes of Normal Pressure Hydrocephalus

NPH occurs when the normal flow of CSF in the brain and spinal cord is blocked, causing the ventricles to enlarge and put pressure on the brain. It can occur after injury or illness to the brain, with suspected causes that include head trauma, brain tumor, subarachnoid hemorrhage, infection, or complications from surgery. Some people develop NPH for unknown reasons. NPH occurs most often in the elderly and it affects both women and men equally.

Early Symptoms of NPH and Diagnosis

Three hallmark symptoms are present in patients diagnosed with NPH: difficulty with balance and walking; dementia and mental decline, including memory loss, difficulty speaking, and changes in mood and/or behavior; and urinary incontinence. Headaches, nausea, and difficulty concentrating may also occur due to the swelling of the brain. NPH is a progressive condition, with symptoms that worsen over time. Because these symptoms are similar to those of Alzheimer’s disease, Parkinson’s disease, and Creutzfeldt-Jakob disease, NPH is difficult to diagnose. Your doctor may conduct a variety of tests, including a physical exam, evaluation of how you walk, CT or MRI scans of the brain, a spinal tap or lumbar catheter, intracranial pressure monitoring, and neuropsychological tests, all of which can rule out other conditions.


Treatment for NPH involves placing a shunt in the brain to drain excess CSF into the abdomen, where it is absorbed as part of the normal circulatory process. Drainage by shunt allows the ventricles to return to their normal size. Early diagnosis and treatment improves the chances that shunt placement will result in a good recovery.

The Face Pain and Headache Clinic at UTHealth Neurosciences brings together a multidisciplinary team of board-certified, fellowship-trained neurosurgeons, neurologists, researchers, and pain management specialists who work together to provide relief for even the most complex problems. People who suffer from migraine, cluster headache, trigeminal neuralgia, hemifacial spasm, normal pressure hydrocephalus, pineal cyst, and other disorders benefit from collaborative, highly specialized expertise focused on managing chronic headaches and face pain.

What You Can Expect at UTHealth Neurosciences

At UTHealth Neurosciences, neurologists, neurosurgeons, interventional pain management specialists, neuro-oncologists, radiation oncologists, and neuropathologists work together to determine the care each patient needs, discussing treatment options as a group. This approach saves our patients time and money and allows our specialists to share each other’s insights, leading to better treatment decision-making and outcomes.

We first investigate options for nonsurgical treatment, including medical management, pain management, physical therapy, rehabilitation, and watchful waiting. When surgery is needed, our neurosurgeons routinely employ innovative minimally invasive techniques. Throughout the treatment process, our team works closely with the doctor who referred you to ensure a smooth transition back to your regular care plan. While you are with us, you can expect expert care, excellent communication, and genuine compassion.

Related Conditions and Treatments

Contact Us

At UTHealth Neurosciences, we offer patients access to specialized neurological care at clinics across the greater Houston area. To ask us a question, schedule an appointment, or learn more about us, please call (713) 486-8000, or click below to send us a message. In the event of an emergency, call 911 or go to the nearest Emergency Room.