brain, spinal cord, and nerve disorders
Normal–Pressure Hydrocephalus
Diagnosis of Normal Pressure Hydrocephalus
A doctor's evaluation Brain imaging, usually magnetic resonance imaging Lessening of symptoms after removal of cerebrospinal fluid Doctors may suspect normal-pressure hydrocephalus when people have the three typical symptoms: Difficulty walking Urinary incontinence Dementia 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 conditions can make walking difficult or cause urinary incontinence. Doctors base a diagnosis of dementia on the following: Symptoms, which are identified by asking the person and family members or other caregivers questions Results of a physical examination, including a Neurologic Examination None Results of a mental status test Results of additional tests, such as computed tomography (CT) or magnetic resonance imaging (MRI) Mental Status , consisting of simple questions and tasks, helps doctors determine whether people have dementia. which is more detailed is sometimes needed. This testing covers all the main areas of mental function, including mood, and usually takes 1 to 3 hours. This testing helps doctors distinguish dementia from other conditions that can cause similar symptoms, such as Dementia , Information from the above sources can usually help doctors rule out delirium as the cause of symptoms (see table Comparing Delirium and Dementia ). Doing so is essential because delirium, unlike dementia, can often be reversed if promptly treated. Differences between the two include the following: Dementia affects mainly memory, and delirium affects mainly attention. Dementia typically begins gradually and has no definite beginning point. Delirium begins suddenly and often has a definite beginning point. Brain imaging, usually magnetic resonance imaging (MRI) is done to check for excess cerebrospinal fluid. Finding excess fluid and other characteristic changes in the brain supports the diagnosis of normal-pressure hydrocephalus but does not confirm it. To help with the diagnosis, doctors do a Spinal Tap (lumbar puncture) or place a temporary drain into the spinal cord to remove excess cerebrospinal fluid. If these procedures relieve symptoms, usually by improving gait, normal-pressure hydrocephalus is more likely, and treatment is more likely to be effective. 