Normal pressure hydrocephalus - Diagnosis and therapeutic challenges

Normal pressure hydrocephalus (NPH) is a rare pathological condition that generally affects older people (>65 years old), and can take one of two forms: idiopathic or secondary. It is a reversible cause of dementia, and it manifests itself through a very specific triad: gait impairment, urinary incontinence, and dementia. The clinical diagnosis of NPH is particularly difficult to establish due to the association between these symptoms and old age, as well as due to the absence of specific paraclinical markers. Nevertheless, a holistic application of clinical, imagistic, paraclinical criteria, as well as of the various developed scales may, in time, lead to a diagnosis. Moreover, the evolution of magnetic resonance imaging has certainly made easier to establish the condition. The sole therapeutic method proven to be efficient is shunting surgery which has good results in the majority of the cases, showing clear signs of improvement from the very first-day post-surgery.