Normal Pressure Hydrocephalus

Normal pressure hydrocephalus (NPH) was first described in 1965 and generated substantial enthusiasm because it was thought to represent a dementia syndrome that could be treated successfully with shunting procedures. The clinical features of NPH include dementia, gait disorder, and incontinence, reflecting primary involvement of the subfrontal white matter. The disorder sometimes follows TBI, infection, or subarachnoid hemorrhage but is frequently idio-pathic. Although undoubtedly some cases exist that have been successfully reversed with a shunt, these cases are disappointingly rare; moreover, complications of the shunt procedure are common. Nevertheless, NPH is a good example of dementia due to potentially reversible structural involvement of the cerebral white matter.

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