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Confident Caucasian senior male neurosurgeon consults with a colleague about a patient's diagnosis. The male doctor is holding a human brain model.
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Normal pressure hydrocephalus can be difficult to diagnose. At our center, we have a unique collaboration of neurologists, neurosurgeons and neuropsychologists to expertly diagnose and treat patients with this condition.
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Understanding normal pressure hydrocephalus

Normal pressure hydrocephalus (NPH) is a mild, difficult-to-diagnose type of hydrocephalus, commonly referred to as "water on the brain." Symptoms of normal pressure hydrocephalus are caused by an increase of fluid in the brain known as cerebrospinal fluid (CSF). The increase in the cerebrospinal fluid above normal levels is so mild that NPH can be hard to detect and accurately diagnose. Individuals with normal pressure hydrocephalus often have a combination of three symptoms that can help establish the diagnosis: mental confusion, gait disturbance and urinary incontinence.

Because NPH symptoms are similar to those of Alzheimer's, Parkinson's and other movement disorders, NPH is often misdiagnosed or unrecognized which results in patients not receiving the appropriate treatment. Without treatment, symptoms may get worse over time, and early diagnosis and treatment may improve the chance of a good recovery.

Providing expert diagnosis

At the Normal Pressure Hydrocephalus Center at the Northwell Health Institute for Neurology and Neurosurgery, we use comprehensive techniques to make sure we make the right diagnosis (and therefore choose the right treatment) including:

  • Detailed patient history and examination 
  • CT scan (Computerized Tomography) of the head
  • MRI (Magnetic Resonance Imaging) 
  • Neuropsychological testing 
  • Gait testing 
  • Spinal tap or lumbar puncture (LP) 
  • Lumbar CSF drainage 
  • Intracranial pressure monitoring 

Research interests

We are members of the International Hydrocephalus Imaging Working Group (IHIWG), an organization that advances the study of hydrocephalus, using a wide range of imaging modalities. Our physicians have presented at IHIWG on cerebrospinal fluid physiology and modeling.

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