Normal Pressure Hydrocephalus

Excerpt

Idiopathic normal pressure hydrocephalus (iNPH) (G91.2 by ICD-10), a potentially reversible cause of dementia, is the most common form of hydrocephalus in adults. iNPH is a disorder of the elderly that characteristically presents with progressive gait impairment, cognitive deficits, and urinary urgency and/or incontinence (Hakim-Adams triad - classically described by Colombian neurosurgeon Salomon Hakim and R D Adams in 1965). Gait disturbance with one additional feature is essential to consider the diagnosis; however, the clinical presentation requires further supportive assessment (i.e., imaging and cerebrospinal fluid (CSF) drainage) for confirmation. Some experts have challenged the term iNPH, as the intracranial pressure is not always normal in iNPH. The term idiopathic adult hydrocephalus syndrome (iAHS) has also been proposed.