Symptoms of Normal Pressure Hydrocephalus

Normal pressure hydrocephalus once again appears in the news. Zig Ziglar, a well known motivational speaker, recently was diagnosed with normal pressure hydrocephalus. About a year ago, Mr. Ziglar had suffered a fall down a flight of stairs, as referenced on a blog from Michael Pink. His family had noticed that Mr. Ziglar was having some memory loss associated with gait unsteadiness.  The characteristic clinical symptoms of normal pressure hydrocephalus are gait unsteadiness, memory loss and urinary incontinence. The exact cause of this condition is unknown but what happens is there is a build up of water (spinal fluid) on the brain. Diagnosis is difficult to make and one should see a neurologist familiar with the condition. The treatment for this is putting a special tube in the brain, known as a shunt. This is a fairly routine neurosurgical procedure.

For the diagnosis of normal pressure hydrocephalus, a patient should first have a CT scan or MRI brain scan. If the spaces in the brain that contain spinal fluid (ventricles) are enlarged, the patient should then have a spinal tap. About an ounce of spinal fluid taken drained off. Then the patient will have gait testing to see if their walking improves. If it does but then worsens a few hours later, the diagnosis is made. A brain shunt can then be permanently put in by a qualified neurosurgeon. Patient’s with true normal pressure hydrocephalus can show dramatic improvements in their ability to walk with gait training rehabilitation. The urinary incontinence will also improve. Unfortunately, if they have a degree of short term memory loss, this procedure will have little if any effect on restoring memory. It is this author’s hope that Zig Ziglar has improved and is doing well with his new brain shunt. To find out more about Zig Ziglar, check his blog site.