**Clinical and Cognitive Features of Idiopathic Normal Pressure Hydrocephalus Pressure Hydrocephalus**

**Clinical and Cognitive Features of Idiopathic Normal** 

DOI: 10.5772/intechopen.73273

Elena Sinforiani, Claudio Pacchetti, Marta Picascia, Nicolò Gabriele Pozzi, Massimiliano Todisco and Paolo Vitali Nicolò Gabriele Pozzi, Massimiliano Todisco and Paolo Vitali Additional information is available at the end of the chapter

Elena Sinforiani, Claudio Pacchetti, Marta Picascia,

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.73273

#### **Abstract**

**Introduction**: Idiopathic normal pressure hydrocephalus (iNPH) is characterized by dilated cerebral ventricles with progressive impaired gait, cognition, and urinary control. Firstly described in 1965 by Hakim and Adam, it remains largely under-diagnosed. The diagnosis is based on clinical and imaging (CT or MRI) investigations; a timely diagnosis and cerebrospinal fluid (CSF) shunt surgery has reported to be beneficial in 60 up to 80% of the cases.

**Body**: The severity of motor and cognitive disturbances varies widely and it can be difficult to distinguish iNPH from other neurodegenerative disorders. The cognitive and behavioral disturbances have been commonly described as "fronto-subcortical dysfunction". However, this definition is reductive not encompassing the entire cognitive spectrum of iNPH deficits. In our sample we found an impairment in respect to healthy controls in all the neuropsychological tests, but verbal memory. We could also find a positive correlation between the severity of cognition deficit and disease progression, suggesting a common pathological mechanism.

**Conclusions**: iNPH can be reliably diagnosed with an organized approach. Neurologists play an essential role in the care of patients and a multidisciplinary team can improve this process. An early shunt surgery might contain the progression of the disturbances and also possibly prevent their development.

**Keywords:** hydrocephalus, neurodegenerative diseases, cognition, aging and dementia, neurogeriatric

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© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons
