Hydrocephalus is a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF).  CSF is produced within chambers in the brain called ventricles.  The fluid circulates around the brain and spinal cord to cushion and support the central nervous system.  CSF is constantly produced and resorbed at a rate of approximately one pint per day.   Spinal fluid can build up in certain circumstances and the ventricles, or chambers, become larger than normal.  This can be seen on a CAT scan or MRI of the brain.  The excessive build up of spinal fluid is called hydrocephalus, and is associated with an increased pressure inside the brain.  Hydrocephalus can occur from a blockage of the normal circulation of fluid, a blockage of resorption, or an over production of CSF. 

Normal Pressure Hydrocephalus (NPH) is a syndrome most commonly seen in older adults.  Spinal fluid builds up in the brain, and the ventricles become enlarged, but it is not necessarily associated with increased pressure, thus the term, Normal Pressure Hydrocephalus.  The syndrome has three main symptoms:  gait disturbance, mild dementia, and impaired bladder control.  Although NPH could occur after brain trauma or infection, most cases of NPH have no known cause.

Gait imbalance, memory loss, and urinary urgency are often associated with the aging process and may be difficult to differentiate from NPH.  If you suspect you or your loved one suffers from NPH, please involve your family physician, a neurologist, and a neurosurgeon to help with the diagnosis. 

A shunt tube can be inserted which drains excess spinal fluid from the brain into the abdominal cavity.  Symptoms of gait imbalance, cognition, and urinary function may improve by draining the excess fluid.  Patients who may benefit from a shunt tube can undergo a trial before surgery to determine if they are likely to get better from the shunt.  A small drainage tube is inserted into the lumbar spine to drain spinal fluid, and the patient is examined for improvements in neurologic function.   

J. Peter Gruen, M.D. at USC Neurosurgeons, Inc. has performed hundreds of intracranial shunt surgeries.  To schedule an office consultation with Dr. Gruen, please dial 323-442-7542.