From the Guidelines
Normal pressure hydrocephalus (NPH) can potentially cause syncope, although it is not a classic symptom of this condition. The primary symptoms of NPH include gait disturbance, urinary incontinence, and cognitive decline 1. However, the altered cerebrospinal fluid dynamics in NPH can affect cerebral blood flow regulation, potentially leading to episodes of cerebral hypoperfusion that trigger syncope.
Some key points to consider in the relationship between NPH and syncope include:
- Altered cerebrospinal fluid dynamics affecting cerebral blood flow regulation
- Comorbid cardiovascular conditions that increase syncope risk
- Autonomic nervous system dysfunction contributing to orthostatic hypotension
- The need for thorough evaluation to determine the cause of syncope in NPH patients
Management of syncope in NPH patients typically involves treating the underlying hydrocephalus, which may include ventriculoperitoneal shunting or endoscopic third ventriculostomy, as discussed in the context of managing increased intracranial pressure and hydrocephalus 1. It is crucial to investigate and address other potential causes of syncope appropriately, given that NPH patients often have multiple comorbid conditions that could contribute to syncopal episodes.
From the Research
Normal Pressure Hydrocephalus and Syncope
- There is no direct evidence in the provided studies that normal pressure hydrocephalus (NPH) can cause syncope 2, 3, 4, 5, 6.
- The studies focus on the epidemiology, pathogenesis, diagnosis, and treatment of NPH, as well as its clinical features, such as gait disturbance, urinary incontinence, and cognitive decline 2, 4, 5, 6.
- None of the studies mention syncope as a symptom or complication of NPH 2, 3, 4, 5, 6.
Clinical Features of NPH
- NPH is characterized by enlarged cerebral ventricles, cognitive impairment, gait apraxia, and urinary incontinence 4.
- The clinical features of NPH may be incomplete or nonspecific, posing a diagnostic challenge 4.
- Recent advances in MRI methods and the association of NPH with obstructive sleep apnea (OSA) offer new avenues to understand and treat NPH 4.
Diagnosis and Treatment of NPH
- The diagnosis of NPH is difficult due to the commonality of its clinical features in older individuals 5.
- Neuroimaging and cerebrospinal fluid (CSF) diversion are the two best diagnostic tests for NPH 5.
- Shunt surgery is a treatment option for NPH, and improvements in shunt technology and surgical techniques have decreased the risks and long-term complications of shunt surgery 5, 6.