Can Normal Pressure Hydrocephalus (NPH) cause confusion?

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Last updated: April 23, 2025View editorial policy

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From the Research

Yes, normal pressure hydrocephalus (NPH) can cause confusion, as evidenced by the clinical triad of symptoms which includes cognitive decline, gait disturbances, and urinary incontinence 1. NPH is a neurological condition characterized by an abnormal buildup of cerebrospinal fluid in the brain's ventricles, leading to cognitive impairment including confusion, memory problems, and slowed thinking. The confusion occurs because the enlarged ventricles put pressure on surrounding brain tissue, disrupting normal brain function despite the cerebrospinal fluid pressure remaining within normal range when measured by lumbar puncture. Some key points to consider include:

  • Patients with NPH may experience progressive confusion that can be mistaken for dementia or Alzheimer's disease 2.
  • Unlike many other causes of cognitive decline, NPH-related confusion may be reversible with proper treatment, typically through surgical placement of a shunt that drains excess cerebrospinal fluid from the brain 3.
  • Early diagnosis and treatment are important, as longer-standing symptoms may become permanent even after shunting 4.
  • The use of programmable valves and gravitational valves in shunt systems has improved outcomes for patients with NPH, although the optimal valve setting and type may vary depending on individual patient needs 5, 4. In summary, NPH is a treatable cause of confusion and cognitive decline, and early diagnosis and treatment can significantly improve patient outcomes 1.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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