Low pressure hydrocephalus

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Low pressure hydrocephalus
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Gait disturbance, urinary incontinence, cognitive dysfunction
Complications	Brain damage, increased intracranial pressure
Onset	Typically in adulthood
Duration	Chronic
Types	N/A
Causes	Impaired cerebrospinal fluid absorption
Risks	Head injury, subarachnoid hemorrhage, meningitis
Diagnosis	Neuroimaging, lumbar puncture
Differential diagnosis	Normal pressure hydrocephalus, Alzheimer's disease, Parkinson's disease
Prevention	N/A
Treatment	Ventriculoperitoneal shunt, endoscopic third ventriculostomy
Medication	N/A
Prognosis	Variable, depends on treatment response
Frequency	Rare
Deaths	N/A

Low Pressure Hydrocephalus

Diagram of cerebrospinal fluid circulation

Low pressure hydrocephalus is a rare form of hydrocephalus characterized by the abnormal accumulation of cerebrospinal fluid (CSF) in the ventricular system of the brain, despite normal or low intracranial pressure. This condition can lead to significant neurological symptoms and requires careful management.

Pathophysiology

Low pressure hydrocephalus occurs when there is an imbalance between the production and absorption of CSF, leading to ventricular enlargement. Unlike typical hydrocephalus, where increased intracranial pressure is a hallmark, low pressure hydrocephalus presents with normal or even low pressure readings. This paradoxical situation can be due to impaired CSF absorption or altered brain compliance.

Clinical Presentation

Patients with low pressure hydrocephalus may present with a variety of symptoms, including:

• Gait disturbance
• Cognitive impairment
• Urinary incontinence
• Headache
• Nausea and vomiting

These symptoms can overlap with other forms of hydrocephalus and neurological disorders, making diagnosis challenging.

Diagnosis

The diagnosis of low pressure hydrocephalus involves a combination of clinical evaluation, imaging studies, and pressure monitoring. Magnetic resonance imaging (MRI) or computed tomography (CT) scans can reveal ventricular enlargement. Lumbar puncture may show normal or low opening pressure, which is a key diagnostic feature.

Treatment

Management of low pressure hydrocephalus often involves surgical intervention. The most common treatment is the placement of a ventriculoperitoneal shunt to divert CSF and relieve symptoms. Adjustments to the shunt system may be necessary to maintain appropriate CSF drainage without causing overdrainage.

Prognosis

The prognosis for patients with low pressure hydrocephalus varies. Early diagnosis and appropriate management can lead to significant improvement in symptoms. However, some patients may experience persistent or recurrent symptoms despite treatment.

See also

• Hydrocephalus
• Cerebrospinal fluid
• Ventriculoperitoneal shunt
• Intracranial pressure

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External links

• Comprehensive information from the National Institute of health.
  

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