Normal pressure hydrocephalus
00:00 / 00:00
Videos
Notes
Normal pressure hydrocephalus
Pathology
Central and peripheral nervous system disorders
Amyotrophic lateral sclerosis
Neurofibromatosis
Sturge-Weber syndrome
Tuberous sclerosis
von Hippel-Lindau disease
Central nervous system disorders
Brain herniation
Broca aphasia
Kluver-Bucy syndrome
Wernicke aphasia
Wernicke-Korsakoff syndrome
Acoustic neuroma (schwannoma)
Adult brain tumors
Pediatric brain tumors
Pituitary adenoma
Ischemic stroke
Transient ischemic attack
Brain abscess
Cavernous sinus thrombosis
Creutzfeldt-Jakob disease
Encephalitis
Epidural abscess
Meningitis
Neonatal meningitis
Aqueductal stenosis
Cerebral palsy
Chiari malformation
Dandy-Walker malformation
Septo-optic dysplasia
Spina bifida
Spinocerebellar ataxia (NORD)
Syringomyelia
Tethered spinal cord syndrome
Alzheimer disease
Creutzfeldt-Jakob disease
Delirium
Frontotemporal dementia
Lewy body dementia
Normal pressure hydrocephalus
Vascular dementia
Acute disseminated encephalomyelitis
Central pontine myelinolysis
JC virus (Progressive multifocal leukoencephalopathy)
Multiple sclerosis
Transverse myelitis
Cavernous sinus thrombosis
Cluster headache
Idiopathic intracranial hypertension
Migraine
Tension headache
Trigeminal neuralgia
Arteriovenous malformation
Epidural hematoma
Intracerebral hemorrhage
Saccular aneurysm
Subarachnoid hemorrhage
Subdural hematoma
Essential tremor
Huntington disease
Opsoclonus myoclonus syndrome (NORD)
Parkinson disease
Restless legs syndrome
Torticollis
Early infantile epileptic encephalopathy (NORD)
Epilepsy
Febrile seizure
Brown-Sequard Syndrome
Cauda equina syndrome
Friedreich ataxia
Neurogenic bladder
Syringomyelia
Treponema pallidum (Syphilis)
Vitamin B12 deficiency
Concussion and traumatic brain injury
Peripheral nervous system disorders
Poliovirus
Spinal muscular atrophy
Charcot-Marie-Tooth disease
Guillain-Barre syndrome
Bell palsy
Trigeminal neuralgia
Carpal tunnel syndrome
Erb-Duchenne palsy
Klumpke paralysis
Sciatica
Thoracic outlet syndrome
Ulnar claw
Winged scapula
Lambert-Eaton myasthenic syndrome
Myasthenia gravis
Nervous system pathology review
Adult brain tumors: Pathology review
Central nervous system infections: Pathology review
Cerebral vascular disease: Pathology review
Congenital neurological disorders: Pathology review
Dementia: Pathology review
Demyelinating disorders: Pathology review
Headaches: Pathology review
Movement disorders: Pathology review
Neurocutaneous disorders: Pathology review
Neuromuscular junction disorders: Pathology review
Pediatric brain tumors: Pathology review
Seizures: Pathology review
Spinal cord disorders: Pathology review
Traumatic brain injury: Pathology review
Assessments
Normal pressure hydrocephalus
Flashcards
0 / 8 complete
USMLE® Step 1 questions
0 / 2 complete
High Yield Notes
13 pages
Flashcards
Normal pressure hydrocephalus
of complete
Questions
USMLE® Step 1 style questions USMLE
of complete
External References
First Aid
2022
2021
2020
2019
2018
2017
2016
Ataxia
normal pressure hydrocephalus p. 540
Normal pressure hydrocephalus p. 540
Transcript
Content Reviewers
Contributors
In normal pressure hydrocephalus, hydrocephalus can be broken down into “hydro” which means water and “cephalus” which means head.
Hydrocephalus, which is also termed as “water on the brain”, is an excessive buildup of cerebrospinal fluid within the brain.
Even though the pressure on lumbar puncture is expected to be increased, in this case, it’s normal, which is why it’s termed as “normal pressure” hydrocephalus.
Let's start with some relevant anatomy. The brain has four interconnected cavities in the brain called ventricles, and each one contains a structure called a choroid plexus.
The choroid plexus is made up of ependymal cells which produces cerebrospinal fluid - a fluid that helps provide buoyancy and protection, as well as metabolic fuel for the brain.
Highest up, are two C-shaped lateral ventricles that lie deep in each cerebral hemisphere.
The two lateral ventricles drain their cerebrospinal fluid into the third ventricle, which is a narrow, funnel-shaped, cavity at the center of the brain.
The third ventricle makes a bit more cerebrospinal fluid and then sends all of the cerebrospinal fluid to the fourth ventricle via the cerebral aqueduct.
The fourth ventricle is a tent-shaped cavity located between the brainstem and the cerebellum.
After the fourth ventricle, the cerebrospinal fluid enters the subarachnoid space, which is the space between the two inner linings of the brain - the arachnoid and pia mater.
Summary
Normal pressure hydrocephalus is a condition characterized by ventricular enlargement, without an increase in cerebrospinal fluid pressure on lumbar puncture. Cerebrospinal fluid (CSF) accumulates slowly and gradually in the ventricles, causing them to dilate. Ventricular dilation restores the CSF pressure to the normal level, hence the normal findings on lumbar puncture.
People with normal pressure hydrocephalus present with urinary incontinence, gait disturbances, and dementia. The excess amount of CSF can be temporarily drained through a lumbar puncture, but the long-term management is a surgical procedure called a ventriculoperitoneal shunt, in which a tube is inserted into one of the ventricles of the brain and directed to the abdomen, where the excess CSF can be absorbed.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "Reference ranges for fetal ventricular width: a non-normal approach" Ultrasound in Obstetrics and Gynecology (2007)
- "Fetal mild idiopathic lateral ventriculomegaly: is there a correlation with fetal trisomy?" Ultrasound in Obstetrics and Gynecology (1993)
- "Postnatal clinical and imaging follow-up of infants with prenatal isolated mild ventriculomegaly: a series of 101 cases" Pediatric Radiology (2007)
For Institutions
Copyright © 2023 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.
