Normal pressure hydrocephalus is one of the rare causes of forgetfulness that can be treated. Due to the prolongation of the average life span, the increase in diseases related to brain tissue (alzheimer's, parkinson's and others),diabetes, high blood pressure and other chronic diseases, forgetfulness and dementia (dementia) have started to be seen more frequently in the society.
Forgetfulness that develops due to the aging process, brain diseases and additional diseases cannot be fully treated. The disease we call normal pressure hydrocephalus is one of the few treatable causes of forgetfulness.
In the type called idiopathic, no obvious cause can be found. In the secondary type; brain hemorrhage, infection, tumor, trauma and other rare causes are found. While the intracranial pressure is increased in hydrocephalus, the pressure is usually normal in normal pressure hydrocephalus.
Slowly progressive forgetfulness, urinary incontinence and accompanying gait disturbance can be seen. These three conditions may be in the same patient, or sometimes two of them may be more dominant. The gait is unsteady, with small steps. The patient has a lot of difficulty in turning. Frequent falls may occur. The patient has difficulty in lifting his feet from the ground while walking, as if something is pulling his feet down. Forgetfulness and urinary incontinence are also common in patients. For all these reasons, patients often stay away from society and social life. With the vicious circle, the current picture of dementia can get worse.
Patients with these complaints must be evaluated by neurology or neurosurgery. After discussing the current complaints in detail with the patient and their relatives, a neurological examination is performed. Afterwards, especially brain MRI, sometimes MRI of the spine, blood tests and some other tests are performed for possible causes of forgetfulness, urinary incontinence and gait disturbance.
Cerebrospinal fluid is taken from the waist in order to confirm the diagnosis and to evaluate the response to treatment in patients who are thought to have normal pressure hydrocephalus based on patient history, examination and tests. Sometimes 1 time may be sufficient, while in some cases, fluid intake from the waist may be repeated more than once.
In very few patient groups, this procedure can be performed by attaching a 4-5-day catheter to the waist. After these procedures, a decision is made in favor of shunting, especially in patients with significant improvement in walking and urinary incontinence in a short time. With this procedure, recovery in forgetfulness can be observed later. (The shunt is the device that transfers excess water from the brain to the abdomen with a subcutaneous catheter).
Much more significant improvement can be achieved in patients who do not have accompanying neurodegenerative diseases (such as Alzheimer's) in the brain tissue. Shunt is a good treatment method in appropriately selected patients so that patients can be adapted to society and social life again, at least to meet their daily needs.