This document provides information on normal pressure hydrocephalus (NPH), including its causes, symptoms, diagnosis, treatment with shunt surgery, and patient outcomes. It discusses how NPH presents with a triad of gait disturbance, urinary incontinence, and dementia. Diagnostic tests include brain imaging and CSF flow studies. Patients with mild symptoms and gait issues are most likely to benefit from shunt surgery, while those with significant dementia tend to show little improvement. However, long-term outcomes of shunt surgery are variable, with benefits often declining over time.

1. Normal Pressure Hydrocephalus Jerry Ryan MD University of Wisconsin - Madison

10. CSF pathway

16. Cognitive Impairments AD versus NPH Auditory memory Attention/concentration Executive function Behavior/personality changes Motor and psychomotor skills Visuospatial skills Language Reading Borderline Impaired Psychomotor slowing Fine motor speed Fine motor accuracy Memory Learning Orientation Attention/concentration Executive function Writing Impaired NPH AD

21. Normal Ventricles

22. Enlarged Ventricles

23. Enlarged Ventricles

24. Enlarged Ventricles

25. Enlarged Ventricles

28. Overdrainage

34. How accurate are predictors of response to shunting? Normal pressure hydrocephalus: an update, Stein, SC, Neurosurgery Quarterly (2001) 11 (1):26–35

35. How accurate are predictors of response to shunting? Normal pressure hydrocephalus: an update, Stein, SC, Neurosurgery Quarterly (2001) 11 (1):26–35

41. MRI flow void Normal fourth ventricle Abnormal fourth ventricle

55. Yet another workup Treating Normal Pressure Hydrocephalus, Luciano, M, AAFP CME Bulletin, 2004, Vol. 3 (4)

56. Yet another workup Treating Normal Pressure Hydrocephalus, Luciano, M, AAFP CME Bulletin, 2004, Vol. 3 (4)

58. What kind of shunt is used?

59. Shunt placement

60. Shunt Valve Adjustments