This disorder affects older patients and is typically seen in patients greater than 65 years old.
This process of decreased CSF absorption occurs insidiously and is difficult to diagnose because the symptoms are common to several other diseases. Primary NPH occurs idiopathically. The secondary type of NPH can be due to a subarachnoid hemorrhage, head trauma, tumor, infection in the central nervous system, or a complication of cranial surgery.
Increased intracranial pressure occurs due to decreased absorption of CSF in primary normal pressure hydrocephalus.
Inadequate fluid absorption leads to abnormal accumulation of CSF in the ventricles of the brain, which can cause the ventricles to enlarge (ventriculomegaly).
This symptom appears late in the illness, and is found to be of the spastic hyperreflexic, increased-urgency type. This is associated with decreased inhibition of bladder contractions and detrusor instability.
Patients show gait abnormalities due to traction on the corticospinal motor fibers descending to the lumbosacral spinal cord.
Patients show cognitive dysfunction, which affects the frontal lobe in nature. It presents in the form of apathy, forgetfulness, inattention, and decreased speed of complex information processing, which is reflective of frontal lobe damage.
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