I just don't understand how NPH can cause compression to structures if the pressure is normal. If there is so much fluid that it is squeezing structures then the pressure has to be high somewhere?
I observed an LP on a patient earlier today who may have had NPH with an opening pressure of 7 and have been trying to make sense of this since. They thankfully also found the procedure therapeutic with relief of their headache.
because you're making me wacky, wobbly, and wet
Given that Jreg has been talking about dementia. According to Reader's Digest June 2021 edition, p. 55 states, "NPH is sometimes referred to as 'treatable dementia."' I thought I'd bring it up, esp. since he's making tier lists of different illnesses.
My mother had been slowly declining physically and cognitively for years, up until her balance was so bad, she couldn’t stand without falling backward. Without my helping her every minute of the day, she would have been permanently in a wheel chair - unable to even operate it. Her walking (even with assistance) became a nothing more then a shuffle and she was unable to really pick up her feet when moving - almost as if she were walking through mud. She also had severe freezing episodes with her feet/legs, especially as she was turning to sit (which she would always just flop in chairs) and changes in flooring when walking (ie carpet to tile, etc) - often time it would be so bad she would have fallen had I not been there all the time - just because of a change in flooring.
Cognitively, her memory deteriorated, her ability to engage in conversation all but disappeared, and she was practically unable to understand even mildly “complex” instructions - sequencing was a big no - as was remembering anything procedural that was simple (ie couldn’t remember out how to use the basic features on a remote control to the TV).
Urinary, she was completely incontinent. Didn’t even know she had to urinate until she was already peeing. Not only did I have to help my mother bathroom and clean for 2 years, I also had to sleep next to her in a recliner during that time, to help her to the commode 2-4 a night (and change pads (and sheets if necessary)).
She was diagnosed with Parkinsonism last July, and at the same time, we got her another MRI ordered. I read the report when it came back and saw that it referenced “characteristics of NPH”, a potentially treatable and reversible condition (which I then found had been referenced in MRIs she had back in 2015 and 2017). Experts suspect that there are over 700,000 people in the US suffering from NPH, with only 20% ever getting the correct diagnosis.
The second neurologist we took her to, we asked him if she indeed did have NPH. And he said “no.” “I wouldn’t even order a lumbar puncture”. Which is bizarre, since that’s the final test to truly understand if a person does in fact have the disease. So we got a 3rd opinion at Mass General Hospital where they said “yes, maybe”. We got her the spinal tap, and she showed improvement. So, we then had 2 neurologists and a neurosurgeon at Mass General all agree that she would more then likely benefit from a shunt
She had the implant in February of this year, and is now independent o
... keep reading on reddit ➡
I'm not much for TV, but my local hydro group on fb just posted about this. figured I'd pass it along.
Have any of you ever heard of this condition before? I brought my mother to get a neurological work up for the first time (so long overdue I won't begin to admit) and within 5 minutes the neurologist printed out information on this condition. The symptoms of it are unsteady/abnormal gait, urinary incontinence, and dementia (possibly reversible). Relieving cerebrospinal fluid pressure is a form of treatment.
I'd have never thought of a cerebrospinal fluid issue in a million years. I thought dementia is dementia, and it might be vascular if you have diabetes, but it's an otherwise one way street. My mother's story is kind of interesting because she did have marked reversal of what seemed to be a very severe dementia (after major change in diet and 2 months of Donepezil). I had always thought "this is it" with her, but the neurologist sees her case otherwise. We're going to get some more tests done for her so we'll see how this pans out.
For some this information could be very pertinent (as a layperson I certainly did not tie the symptoms together). Definitely seek out a neurologist.
Hi there. This may sound like a strange question, but I was trying to touch base with people who have experience with NPH.
My father had a stroke back in November last year. Since then he's been recovering in some ways but going backwards in others.
In the days after the stroke he had a facial droop and weakness in his right side which has improved gradually.
But one thing that is getting worse is his balance. He uses a cane to get around and has had quite a few instances of falling over while standing, and really struggling to get up off a couch or out of bed.
Compare to the last few years his cognitive abilities haven't changed that much (He's always complained of bad memory).
When he walks he used to stand upright - almost like he was marching. But I recall a time about 3 weeks BEFORE his stroke that his walking pace slowed substantially and he started to develop what we jokingly called his "old man shuffle" (he is 67).
Lately my mother told me that he has developed a urinary incontinence.
I guess the fact that his "changes" started before the official stroke make me wonder if he has had a condition for longer which has been gradually getting worse - in particular, I'm wondering if he should be checked out for NPH.
Would anyone here care to describe their experiences with the condition?
TIA!
I am 37m black united states 280lb 5'6" tall and. I have no conditions besides the one listed in the title normal pressure hydrocephalus and empty cellus I dont have a shunt and I have severe migraines. I stopped seeing my neurologist because he told me that my headaches were not because of the hydrocephalus. I was hospitalized for 1 week when it was first discovered so they could run test I was having blurred vision, dizziness, vertigo, and really fatigue, and body aches, disoriented, and headaches. I do still have these episodes like 3 times a month month they last a1-5 days. I have tried to explain this to my primary care doctor everyone just treat me for the migraine not the other stuff that happens like the vision problems and the disorientation. I always have a slight headache. I have seen eye doctor etc and the only thing that I can comeback to due to my research is normal pressure hydrocephalus but no one will treat me for this.
Can anyone give me your personal guess on how many of the patients referred for normal pressure hydrocephalus actually end up being shunted with effect?
I can't seem to find this in the literature and I'm not sure it exists, either.
I want to use this number to compute the effect of the various (seemingly useless when negative) tests for NPH.
Thank you.
The extra section of the card goes on to state "rarely occurs due to increased production of CSF by choroid plexus papilloma."
If this is the case, then what is the difference in pathology between communicating high-pressure hydrocephalus and normal pressure hydrocephalus? I thought both were due to decreased CSF absorption, with the difference being that you also have increased CSF production in communicating high pressure hydrocephalus.
Age - 81
Sex - M
Height - 5'7"
Weight - 180lb
Race - Caucasian
Symptoms - poor balance/shakiness/dizziness, swallowing issues, nystagmus, hand tremors, memory issues
Duration of complaint - worsening over several years
Any existing relevant medical issues (if any): hypertension, hypothyroidism
MRI results (text, no images available): https://imgur.com/a/3YPYjZX
My grandpa got an MRI of his head because he's been having increasing dizziness & cerebral symptoms. The doctor explained that Parkinson's disease or a stroke were possibilities that they were looking into.
These results were automatically released in his online chart, but he isn't able to have an appointment with his doctor until after the new year. No images accompanied these notes. I understand that meeting with the doctor who ordered the results will explain a lot, but my grandparents are pretty stressed during this two-week waiting period before they're able to get an appointment, so any light that you can shed on these results would be much appreciated, particularly whether or not these results rule in or out Parkinson's disease, Alzheimer's, a stroke, or normal pressure hydrocephalus.
Thank you!
I can't even laugh. Fucking ridiculous. I'm seeing a psychiatrist and therapist (edit: who are separate people) because I've been searching for a job and it has me so stressed out I'm having panic attacks. My standards are incredibly low (living wage, and that it doesn't make me want to kill myself). The idea that a part time food service or retail job would do anything but make me feel worse is laughable.
It's good to have structure, but I am doing everything I can to avoid going back to retail or food service for as long as I fucking can. If the choice is between starving fast or slow, I would rather starve quickly than go back to working at a job where I'm treated as less than human for peanuts just to take a little longer starving. Living wage or fuck off. Fuck. Being told by my PSYCHIATRIST that my minimum standards of a livable wage was unrealistic is incredibly demoralizing.
Edit for clarity
This will also coincide with AMC’s stellar Q4 earnings report & be the catalyst of the final run up to Valhalla once the shorts last ditch efforts fail & they realize they really can’t get rid of us. I’m sure there are tons of people salivating at the thought of buying AMC in the teens or lower again
I like using the slow cooker mostly but I'm open to all and I really like soups, but can't have canned soup anymore so any cheap and healthy (and easy) recipes are more than welcome!
25, Female. Average height and weight. Several medical conditions over the last 5 years (arthritis, ovarian cysts, depression). Currently switching from Topamax to zonisamide to help headache pain management. Several depression medications (abilify, lamictal)
Sometime around April of 2016 I started having headaches, pressure in my head, tingling down my right arm and leg, an increased sense of smell, a few memory problems here and there, but mostly my biggest symptom and worry was my headaches.
MRI's and CT scans revealed my ventricles in my brain were huge. I had a MRI from 2006 that showed my ventricles were normal so congenital defects were ruled out. After many tests, including testing the CSF, the doctors said that they didnt have an answer for why I have hydrocephalus, and that it was idiopathic.
I had an adjustable VentriculoPeritoneal shunt installed to drain the excess CSF into my peritoneal cavity. After surgery, everything started getting much better. My CT and MRI scans showed I no longer had hydrocephalus and my ventricles were normal sized. For about 3 months following the surgery my headaches and other symptoms were pretty much gone.
3 months after my surgery my symptoms started slowly coming back. My headaches are now very bad. BUT the confusing part is that my CT scans show that my ventricles are still normal. My neurosurgeon doesnt think the shunt is the problem and doesnt want to mess with the setting. He said maybe I should be treated for migraines. My neurologist said he doesnt think its migraines, but he can try migraine medication anyways.
Im very confused because I feel the same symptoms as I did before the shunt. Obviously the shunt worked for 3 months because it relieved my symptoms. There isnt any evidence that the shunt isnt working besides my symptoms. No one has an answer for what is going on so it is very frustrating being in constant pain without a direction for care.
I posted about this in /r/hydrocephalus. I know this is extremely rare, especially for anyone my age so im not expecting much from /r/askdocs, but any information about hydrocephalus symtpoms coming back after shunt surgery would be greatly appreciated. Thanks!
I was born prematurely and was fitted with a lumboperitoneal shunt at 4 months, due to hydrocephalus (too much fluid in the brain). I've lived a fairly normal life since, up until i was about 17, when I started getting bad headaches. For five years, my doctor treated me for migraine. Migraine medication did nothing for me, only opiates helped. My "migraine" attacks got more frequent and intense over the next few years, and all I could do was take pain-medication. It controlled my pain enough so that I could hold down a 60% job as a salesperson at an electronics store.
Around February this year (I am now 23), I started thinking that maybe my pain had something to do with my shunt. I talked to my doctor, who had actually forgotten that i had hydrocephalus, and I was referred to a neurosurgeon. I took an MRI, and it was discovered that I had very small ventricles. Basically, my shunt was working too well, draining too much fluid. I was super happy that they had finally found out what was wrong with me, and I was looking forward to becoming headache free. I was scheduled for an operation to remove my shunt May 18th. Little did I know that this operation would ruin my life.
After this operation everything was fine for a couple of days. I was sent home, but had to rush back to hospital since my incision was leaking spinal fluid. They sewed me back up and had me on forced bed rest for five days. Was discharged, same thing happened. Back to hospital to get sown up again. Forced bed rest for 10 days. Discharged. Same thing happened. Back to hospital, this time for an operation to patch up the leaking dural sac.
After this operation I got really, really sick. The pressure in my head went up to dangerous levels, I was in the worst pain of my life, and fading in and out of consciousness. So, I was scheduled for an emergency operation to fit a new shunt in my head.
To shorten things a bit, I will not go into detail about all the procedures, but the shunt failed and I had to undergo 8 operations from May to the end of August. I was in hospital basically all of that time.
When I was discharged they said I had to lower my expectations. That I was probably going to have to live with pain. There is nothing more they can do at the moment. And I'm living with pain alright.
I can't work anymore, and i'm bedridden most days. Before all these operations I could go out with friends and hold a job, my pain was well under control with tramadol. Now I take oxycontin and ox
... keep reading on reddit ➡Got in my car to head home from work and had a warning that I had critically low air pressure in a tire.
By the time the to truck showed up the service center was closed and I’m 2 hours behind schedule.
It would have been extremely helpful for the app to tell me earlier that something was going wrong. That way I could have started working to resolve the issue sooner and coordinate snagging a ride home from a coworker.
TLDR; have the app alert you ahead of time if your car is undrivable
My partner and I are off grid. No solar yet, just Honda generators. We have a small 320sft cabin on 160 acres we purchased last year in Northern California. It's been a slow grind to get it ready to live in but we had to move there before we are ready. Resulting in me scrambling to get my lovely girlfriend a shower! She travels 2 hrs each day for work and has to shower at a friend's every day. We farm and just showered outside all year until October. I have built a small insulated shower room outside and I am looking for a tankless propane, low pressure hot water heater. I have been looking around, but I would really appreciate some feedback from people living offgrid and some recommendations for brands and models. Our water storage situation is a 1000 gallon tank outside that my neighbor comes and fills with well water, until I can get lines to our cabin from our stream network and we'll. Any ideas and help would be appreciated
It was an incredible buying experience. I walked in, picked out my model, color and options. These are my dream cars, still under manufacturer wrap, brand spanking new, no farts, no miles, nothing.
Store was super busy but everyone there was super helpful.
Chip shortage? Don’t believe the hype. This particular store, Safeway, had all kinds of chips.
I elected for the self checkout option. Thanks to everyone here for their advice.
https://imgur.com/a/GNCWF81 The new cars!
The Cro pump is going to be a snowball effect. The more the price pumps the more people are staking their token for their cards. The annual reward for staking is about 10% per year, which means that out of every 100 staked Cro's, only 10 Cro are inflating the market per year! In addition supercharger, crypto earn and defi have also a huge impact on the circulating supply.
With the strong marketing and growing userbase I don't see Cro will cool off or have a huge correction, because the buying pressure is way too high. And don't forget the US exchange
If you compare Cro and BNB, Cro has the same path. 7-8x in 1-2 month ->staying stable for a short time ->then 3x again
