Normal Pressure Hydrocephalus

Normal Pressure Hydrocephalus

Normal pressure hydrocephalus, a form of adult hydrocephalus, is a type of hydrocephalus that usually occurs in adults age 60 or older. It also can occur in younger adults, but that is less common. Normal pressure hydrocephalus occurs gradually over time.

Symptoms of normal pressure hydrocephalus are similar to the symptoms of dementia. Sometimes adults are told they have dementia, but they really have normal pressure hydrocephalus. When normal pressure hydrocephalus is properly identified, treatment is successful more than 80 percent of the time.

What is hydrocephalus?

Cerebrospinal fluid helps protect and cleanse the brain. This fluid flows around the brain and through cavities called ventricles before it drains into the bloodstream. Hydrocephalus is often called “water on the brain” because it occurs when cerebrospinal fluid builds up faster than it can drain. The skull can’t expand, so the extra fluid puts pressure on the brain. The brain is the body’s command center, so the extra pressure may cause symptoms in different parts of the body.

What is normal pressure hydrocephalus?

When an injury or illness in an adult causes cerebrospinal fluid to build up in the ventricles, it is called normal pressure hydrocephalus. For a while, the ventricles expand to make room for the extra fluid. Eventually, however, the fluid puts pressure on the brain. The pressure causes symptoms that are similar to dementia or Alzheimer’s. Because normal pressure hydrocephalus usually occurs in adults who are 60 years old or older, it may seem as if the patient has dementia.

What are the symptoms of normal pressure hydrocephalus ?

Normal pressure hydrocephalus has three main symptoms:

  • Trouble walking, standing or balancing (gait)
  • Trouble remembering things or identifying familiar objects (cognition)
  • Trouble controlling your bladder (urinary incontinence)

Some patients also complain of headaches or dizziness.

When to ask whether it’s dementia or NPH

You should be evaluated by a doctor to see if you have normal pressure hydrocephalus if:

  • You are 60 years old or older
  • You have all three symptoms of normal pressure hydrocephalus at the same time
  • A doctor has told you that you have dementia


Neurosurgeons at Swedish Issaquah have one of the few programs in the United States dedicated to diagnosing and treating adults with normal pressure hydrocephalus. If a doctor has told you – or a loved one – that you have dementia, learn more about normal pressure hydrocephalus and consider asking for a second opinion.

Normal Pressure Hydrocephalus Program