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  • Shunt infection: How it develops and how it can be prevented
    • Shunt therapy is the most common treatment for hydrocephalus, but carries the risk of serious complications such as shunt infections. Find out more about symptoms, causes, treatment options and preventive approaches such as antibiotic-impregnated catheters.
  • LP shunt vs. VP shunt
    • The choice between LP and VP shunt is essential for the successful treatment of hydrocephalus. This article provides a detailed comparison, looking at the indications, benefits and potential risks of both types of implantation - informed insights for better treatment decisions.
  • The Innovative Leap to Telemetric Pressure Sensors
    • Telemetric pressure sensors are setting new standards in the hydrocephalus shunt therapy. The article analyzes the technical limitations of conventional ICP sensors and presents trend-setting innovations in the field of measurement with telemetric pressure sensors - for more precise and efficient treatments.
  • ICP – the measurement of intracranial pressure
    • The measurement and interpretation of intracranial pressure (ICP) is a very helpful aid in the diagnosis and treatment of many brain diseases. The article explains the technical requirements for ICP measurements, the interpretation of ICP values in intracranial pressure measurements and their significance for effective treatment planning.
  • Over- and underdrainage - the most common “side effects” of shunt systems
    • Shunt systems in hydrocephalus therapy have a long history, but over- and underdrainage are still common complications with their potential consequences, such as slit ventricle syndrome. The article looks at the causes, consequences and therapeutic approaches of both problems and discusses whether gravitational technology offers a possible remedy.
  • Foundations of fluid mechanics, or of beakers, bottles and people
    • The article introduces fluid mechanics and explains how the cerebrospinal fluid works in the human brain. It explains the hydrodynamics in the shunt system and shows why the circulation and pressure of the cerebrospinal fluid are important factors for optimizing shunt therapies.
Older couple enjoying outdoor activities after successful treatment of normal pressure hydrocephalus (NPH).

Normal Pressure ­Hydrocephalus
Normal signs of aging
or NPH?

We Understand NPH
Symptoms
Diagnosis NPH
Treatment of NPH
Valve technology
References

What is Normal Pressure Hydrocephalus (NPH)?

NPH is a specific form of hydrocephalus that primarily affects older people. Typical symptoms include unsteadiness, cognitive impairment, dementia and urinary incontinence, and these usually develop gradually. Forgetfulness is often mistakenly attributed to Alzheimer's disease and gait disturbance to Parkinson's disease. However, if detected early, NPH is treatable: symptoms can be significantly improved by implanting a drainage system (shunt). 

Studies show that approximately 3.7% of people over 65 and around 9% of people over 80 are affected.1 Nevertheless, NPH is frequently misdiagnosed, and each missed diagnosis represents an opportunity for treatment and a better quality of life that is lost.2

 

Healthcare professional consulting with an older person about symptoms related to normal pressure hydrocephalus.

Symptoms

The typical symptoms of normal pressure hydrocephalus are known as Hakim's triad:

gait disturbance, cognitive impairment/dementia, urinary incontinence.

The severity of these symptoms can vary greatly from person to person and they are often mistaken for the typical signs of ageing. If NPH is suspected, specific neurological examinations should therefore be carried out.

More about NPH Symptoms

Diagnosis NPH

Various diagnostic procedures are used to diagnose normal pressure hydrocephalus (NPH). In addition to imaging techniques such as MRI and CT scans, functional tests such as the spinal tap test are often used.

An accurate diagnosis is crucial because NPH symptoms are often mistaken for Alzheimer's disease or other forms of dementia.

more about the diagnosis of NPH 

Medical professional reviewing MRI scans for the diagnosis of normal pressure hydrocephalus (NPH).
NPH patient Heinz Weber in an interview setting discussing experiences with normal pressure hydrocephalus (NPH).

 

Living with NPH

Heinz Weber talks about his long journey to being diagnosed with normal pressure hydrocephalus (NPH) and how he has been since then.

WATCH VIDEO

Surgical team performing a neurosurgical procedure for the treatment of normal pressure hydrocephalus (NPH).

Treatment

Unlike Alzheimer's disease or other forms of dementia, normal pressure hydrocephalus can be effectively treated. This typically involves the implantation of a shunt, which is a drainage system that regulates and drains excess cerebrospinal fluid. Many patients experience significant improvement in their symptoms.3

Treatment with a Shuntsystem

Valve Technology

Patients with NPH usually have a shunt implanted to treat the condition. Gravitational valves control the amount of cerebrospinal fluid drained. They provide a reliable treatment option and can help to improve quality of life.4

GRAVITATIONal TECHNOLOGy

MIETHKE shunt and valve systems used in the treatment of normal pressure hydrocephalus (NPH).

Janet VanValkenburg

NPH/Dementia Manager SHINE

“Shine has developed a dedicated Normal Pressure Hydrocephalus (NPH) support service in response to the growing number of people living with NPH. NPH is one of the few potentially treatable causes of dementia-like symptoms, yet frequently misdiagnosed as Alzheimer’s or Parkinson’s. Greater awareness is essential, recognising the key symptoms—gait changes, cognitive decline, and urinary incontinence—can lead to timely evaluation and potentially life‑changing treatment. Through research, patient experience, and awareness efforts, Shine aims to improve understanding of NPH, support its members, and drive meaningful system change.”

Go To Shine

We Understand the Gravity of the Situation

B. Braun and MIETHKE share a common vision: improving the lives of hydrocephalus patients worldwide through innovative solutions.

We believe that responsibility, precision and empathy are all connected. This belief is the reason behind every technical solution we develop. This attitude is reflected in our work every single day.

 

We develop innovative solutions for people with hydrocephalus, based on our deep understanding of the challenges they face and the requirements of clinical care. Through close partnerships with physicians and the use of precise gravitational technology, we are striving to make treatment safer, more reliable and more successful in the long term.

 

Our Strong Partner in Neurosurgery:

www.bbraun.com

References

1. Andersson J, Rosell M, Kockum K, et al. Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. (2019) PLoS ONE 14 (5): e0217705. https://doi.org/10.1371/journal.pone.0217705

2. Petrella G, Ciarlo S, Elia S, et al. A. Idiopathic Normal Pressure Hydrocephalus: The Real Social and Economic Burden of a Possibly Enormous Underdiagnosis Problem. (2023) Tomography, 9, 2006–2015. https://doi.org/10.3390/tomography9060157

3. Luciano MG, Williams MA, Hamilton MG, et al. PENS Trial Investigators and the Adult Hydrocephalus Clinical Research Network. A Randomized Trial of Shunting for Idiopathic Normal-Pressure Hydrocephalus. (2025) The New England journal of medicine, 393(22), 2198–2209. https://doi.org/10.1056/NEJMoa2503109

4. Lemcke J, Meier U, Müller C, et al. Safety and efficacy of gravitational shunt valves in patients with idiopathic normal pressure hydrocephalus: a pragmatic, randomised, open label, multicentre trial (SVASONA). (2013) Journal of neurology, neurosurgery, and psychiatry, 84(8), 850–857. https://doi.org/10.1136/jnnp-2012-303936