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Normal pressure hydrocephalus

Last reviewed: 12 Sep 2025
Last updated: 12 Aug 2025

Summary

Definition

História e exame físico

Principais fatores diagnósticos

  • levodopa-unresponsive gait apraxia
Detalhes completos

Outros fatores diagnósticos

  • cognitive impairment
  • urinary frequency, urgency, or incontinence
  • fecal incontinence
Detalhes completos

Fatores de risco

  • age >65 years
  • vascular disease
  • diabetes mellitus
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • MRI head or CT head (without contrast)
  • levodopa challenge
Detalhes completos

Investigações a serem consideradas

  • lumbar puncture
  • lumbar puncture with large-volume cerebrospinal fluid (CSF) tap
  • prolonged external lumbar drainage
  • cerebrospinal fluid (CSF) infusion procedure
  • continuous intracranial pressure monitoring
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

suitable for surgery

not suitable for surgery

Colaboradores

Autores

Richard Adam Grünewald, MA, DPhil, FRCP
Richard Adam Grünewald

Consultant Neurologist

Honorary Clinical Senior Lecturer

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield

UK

Declarações

RAG is the author of a paper cited in this topic.

Agradecimentos

Dr Richard Grünewald would like to gratefully acknowledge Mr Jeremy Rowe, a previous contributor to this topic.

Revisores

Robin Wilson, MD, PhD

Associate Director

Adult Hydrocephalus Center

Sandra and Malcolm Berman Brain & Spine Institute

Sinai Hospital

Baltimore

MD

Declarações

RW declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

INPH Guidelines Study Group. Guidelines for the diagnosis and management of idiopathic normal pressure hydrocephalus. Neurosurgery. 2005;57(Suppl 3):S2-1-S2-52.Texto completo

Halperin JJ, Kurlan R, Schwalb JM, et al. Practice guideline: Idiopathic normal pressure hydrocephalus: Response to shunting and predictors of response: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2015 Dec 8;85(23):2063-71.Texto completo  Resumo

Artigos de referência

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