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< Back to Differential Diagnosis

Differential Diagnosis of Normal Pressure Hydrocephalus

Key features

Normal Pressure Hydrocephalus (NPH) is a rare disorder that involves the build-up of fluid in the brain. It typically has three symptoms:

  1. difficulty walking
  2. loss of bladder control and
  3. mental decline

A person's cognitive responses become delayed, but they tend to be accurate and appropriate to the situation when they finally come. Gait problems and incontinence are common in the late stages of all dementias, but they are rarely prominent early features except in NPH.


NPH can occasionally be treated by surgically inserting a shunt to drain fluid from the brain to the abdomen. This treatment tends to help more with walking and bladder control than with mental decline.


NPH occurs when fluid surrounding the brain and spinal cord is unable to drain normally. The fluid builds up, enlarging spaces in the brain called ventricles. As the ventricles expand, they can compress and damage nearby tissue.

For your patients and families: Normal Pressure Hydrocephalus


Alzheimer's Association

Our vision: A world without Alzheimer's disease®.
Formed in 1980, the Alzheimer's Association is the leading voluntary health organization in Alzheimer's care, support and research.