Normally, the fluid that surrounds the brain and protects it from injury (cerebrospinal fluid) is produced continuously in the spaces inside the brain (ventricles), circulates around it and is reabsorbed. Normal pressure hydrocephalus is believed to occur when this liquid is not reabsorbed in a normal way, causing it to accumulate. The amount of fluid in the ventricles increases and the brain is then pressed out.
In general, the main symptom of normal pressure hydrocephalus is general instability and loss of balance. Normally, people have an abnormally slow, unsteady walk with their legs spread wide. The feet may appear to be attached to the floor (called a magnetic step). People also have urinary incontinence and a tendency to fall.
The dementia can not develop until the end of disease. Often, the first signs of dementia are difficulty in planning, organizing, exposing ideas or taking actions for a task in the right order (in sequence), thinking abstractly and paying attention. Memory tends to be lost later.
- Evaluation of a doctor
- Brain images, usually magnetic resonance imaging
- Removal of cerebrospinal fluid
Doctors may suspect normal pressure hydrocephalus when people experience the three typical symptoms:
- Difficulty walking
- Urinary incontinence
However, the diagnosis of normal pressure hydrocephalus cannot be based on symptoms alone, particularly in older people. Other dementias can cause similar symptoms, and in older people, many illnesses can make walking difficult or cause urinary incontinence.
Diagnosis of dementia
Neurologist in Delhi base the diagnosis of dementia on the following:
- Symptoms, which are identified when asking the person and their family members or other caregivers
- Results of a physical examination, including a neurological examination
- Mental state test results
- Additional test results, such as computed tomography (CT) or magnetic resonance imaging (MRI)
Mental state tests, consisting of simple questions and tasks, help doctors determine whether people have dementia.
Sometimes, more details for the tests (called neuropsychological tests) are needed. These exams cover all major mental functions, including mood, and take 1 to 3 hours. This test helps doctors distinguish dementia from other conditions that can cause similar symptoms, such as wear of the memory associated with age, the mild cognitive impairment and depression.
Information from the sources above can generally help doctors rule out delirium as the cause of the symptoms (Comparison between delirium and dementia). Doing so is essential as delirium, unlike dementia, can often be reversed if treated quickly. The difference between the two includes the following:
- Dementia mainly affects memory and delirium mainly affects attention.
- Dementia usually has a gradual onset and not a definitive onset. Delirium starts suddenly and often starts definitively.
Diagnosis of normal pressure hydrocephalus
Brain images, usually magnetic resonance imaging (MRI), are taken to check for excess cerebrospinal fluid. Finding excess fluid points to the diagnosis of normal pressure hydrocephalus, but does not confirm it.
To help with the diagnosis, neurosurgeon in Delhi perform a lumbar puncture or place a temporary drain on the spinal cord to remove the excess cerebrospinal fluid. If these procedures alleviate symptoms, normal pressure hydrocephalus treatment in Delhi is likely to be effective.
Normal Pressure Hydrocephalus Treatment in Delhi
- A shunt in the brain’s ventricles
The normal pressure hydrocephalus treatment in Delhi consists of placing a piece of plastic tube (a lead) in the ventricles of the brain and passing it under the skin, usually up to the abdomen (ventriculoperitoneal leads). The cerebrospinal fluid is then drained from the brain. The effects of this treatment may not be evident for several hours. This procedure can significantly improve the ability to walk and coordinate and can decrease incontinence. However, mental function improves less and in fewer people. Thus, early diagnosis is important, so that people can be treated before the development of dementia.
Other normal pressure hydrocephalus treatment in Delhi are similar to treatments for other types of dementia.