This hydrocephalia is a different form of dementia from Alzheimer's, but I wonder if any of you know of anyone who's had this diagnosis and underwent the surgery for the shunt? If so, was the dementia improved? Can the person also have Alzheimer's at the same time?
PrisR, I had a patient many years ago who started developing dementia. He turned out to have NPH and had a shunt. His dementia cleared, and did not return. He died several years later of an unrelated disease.
Pris, there was a local man who had the shunt procedure....I do not know him personally, but the story that was either in print or on TV told of his remarkable recovery from NPH. He was initially diagnosed with AD and then some testing showed the fluid and he chose to try the shunt. He can walk again, is now continent of urine and the confusion is gone.
Glad to hear some positive comments. DH has appt. Mon. with neurosurgeon. His PCP is a geriontologist and, after the memory screening, suggested blood tests and an MRI. The MRI told the story, it's NPH. I'm hopeful, but a little bit scared too. Send good thoughts my way!
PrisR, I think this is probably the most positive diagnosis you could get. This is good, and yes, scary. Sending not only good thoughts, as requested, but also prayers and a hug.
PrisR, at one time DH's neuro thought NPH might be the problem here. As I recall one of the tests they were going to do was a fluid draw several times over a period of a few days to monitor how quickly it built back up.
Keep us posted on how things go. Hoping and praying this is the solution for ya'll.
When I first read about NPH I requested testing for DH. I SOOO wanted to be NPH. No such luck, still AZ/LBD. I've heard only good things about the outcome of the surgery and my thoughts and prayers will be with you.
My 91 year old dad has NPH, and I have spoken at length to his neurologist about it. It affects gait and balance. My Dad falls sometimes even when he is holding on to his walker. It generally progresses to dementia, and yes, all symptoms clear up when the fluid is drained via shunt.
For reasons no one can figure out, my Dad's case never progressed to dementia. My sister and I call him one sharp old dude. And at 91, we all made the decision, including him, not to subject him to brain surgery.
So if your husband can have the shunt put in, his symptoms should clear. What a wonderful blessing! Please let us know how it goes.
This is the condition I started a thread on a few weeks back. Dr. Donahue (?), it may not be Alz. but NPH. I don't know the exact wording of the thread, but it was very informational. Maybe someone could locate it & provide for PrisR. Yes, someone had the shunt surgery & the dementia was reversed by it. There were tests to determine it that were precise, and there were symptoms that were atypical of Alzheimer's.
Here you go PrisR ......... Kitty originally posted this information ....... sounds like something we should all be aware of and look into ...... HTHs ........ Bar-bra
CommentAuthorKitty CommentTimeJun 25th 2009 edited This was in my local paper, a doctor's column. I thought it was interesting, informative.
Dear Dr. Donohue: My wife, 78, has had headaches, some memory problems and confusion. A brain scan showed hydrocephalus. We were referred to a neurosurgeon, and ordered an infusion study. We have waited 6 weeks for that appointment. At an earlier appointment, we met someone who had had the infusion study and then had a shunt placed. He said he got his life back. Someone told us that 10% of people diagnosed with Alzheimer's Disease really have normal pressure hydrocephalus, which is fixable. What is your reaction to this? J.R.
Dear J.R.: Dementia is a fog that descends on the brain, erasing memory and impairing many other mental functions. Alz. is the major cause of dementia. But there are other causes, and one of them is normal pressure hydrocephalus. I can't vouch for the statement that 10% of Alz's patients have NPH, but I am sure there are a few who do. I don't want to raise false hopes for Alz. patients.
In NPH, the balance between the production and absorption of cerebrospinal fluid is lost. The volume of fluid within the brain increases and compresses it. That leads to the signs and symptoms of NPH.
The 3 major indicators of NPH are an abnormal walk, a diminution of memory and other mental functions (dementia) and an urgency to empty the bladder with frequent loss of bladder control. The NPH gait is one where steps are taken slowly, in short strides and with the legs wide apart. A person doesn't need all 3 criteria to merit the diagnosis.
If signs, symptoms and tests point to MPH, then drainage of the excess brain fluid often can restore a person's life, as the man you met said. A plastic tube (a shunt) drains the fluid to other body sites where it is absorbed.
If the above helps one person visiting this site, then it was worth typing. :-)
Thank you Bar-bra. Hope this helps PrisR. PrisR, sounds like your husband may be one of the lucky few. Good luck with the surgery. Sounds like it will clear up the dementia.
I wasn't sure if I should mention NPH on an AD message board, but want you all to know how much your support means to me. My husband's wonderful daughter found these boards for me and they've been such a help these past few months. I still can't believe we actually got him to go to the dr. and to follow his suggestions. Tomorrow morning's visit with the neurosurgeon will tell the story. Thanks and I'll keep you informed about what's going on.
Pris, my H doesn't have Alzheimer's either. But not so fortunate as you, the dementia can't be reversed. But it does seem to work in a way not like AD. Yes, please let us know, it will be great if someone else finds this & seeks the correct medical diagnosis. Hopefully, your message will reach someone else whose spouse has NPH and not AD.
I guess the main thing is to GET AN MRI, insist on it. I've learend so much in such a short time that it's just mind-boggling. The fact that his dr. who he hadn't seen in ages, since he never gets sick, turned out to be a geriontologit and was receptive to talking to DH's daughter confidentially (and unknown to DH) made the initial visit very good. He just eased into the whole problem gradually, gently but firmly saying he needed the MRI and later explaining what the results meant. And DH, who's always been very resistant to the idea of taking meds, is amazed at what the small dose of Seroquel has done for him, says he's never felt calmer or more alive.
Just returned from disappointing dr. visit with neurosurgeon.Dr. doesn't think brain fluid is causing memory problems because gait isn't bad and there's no incontinence, which are the first signs before memory problems show up. He's making an appt. for a spinal tap to see if maybe that helps. If it doesn't, then the shunt would NOT be done. Said he doesn't really have a lot of hope.
I think it's just sinking in a little to him that he actually has memory problems. He was unable to answer some simple questions about recent events in the news, name of the Tampa baseball team, today's date (he said it was August 6)
Pris, Haven't been on the website lately so just saw your post. My dh was diagnosed in 2001. In 2004, he had a mini stroke. While admitted at Yale, they kept him for observation. Midweek, the neurosurgeon asked me many questions about dh symptoms. At the time I saw a definate gate difference and he seemed to walk tilted. He was having some hard times with continence. They finally did a lumbar puncture and tested his walk. It was miraculous! Gate changed and he was walking straighter!! They thought he might have nph and talked about a shunt placement. Well, of course, we were thrilled. ANy thing that offered so much hope was worth exploring. I went on the web and did some shunt research and found the " cadillac" of shunts was available through this one neurosurgeon at UCONN. We had him implant the shunt and the symptoms were better- for a while. Hw was dz with eoad originally and after a few weeks, although the walking and continence were better, the underlying dementia was still there. When I first read your original note, those old feelings of hope were revived. I know exactly how you felt. We all keep that little area in our heart hoping for a miracle. Although the initial news was not great, don't give up hope. Be certain the person doing the puncture is highly qualified and you will probably know your answer rather quickly. I will cross my fingers for you both. Good luck.
Pris, according to the article above, a person doesn't need all 3 criteria to merit the diagnosis. A second opinion? I know this must be a tremendous disappointment. I'd try to find someone who specializes in NPH. Is this doctor just going to leave the excess fluid on the brain?
He's scheduled for the lulmbar puncutre a week from Friday, July 30 and I'm supposed to watch for a month and see if the memory and cognitive issues improve, but not get my hopes up. If there IS noticeable improvement, then the neurosurgeon will put in a shunt. If not, then we go on to a neurologist. We'll also be seeing his PCP, who's a geriontologist, who has shown great interest and sensitivity to this problem. He's the one who ordered the MRI in the first place. I'm just not going to let any stone go unturned, because I think being proactive is the only way to deal with problems of any kind.