What is the primary treatment for normal pressure hydrocephalus?

The primary treatment for normal pressure hydrocephalus involves the placement of a ventriculoperitoneal (VP) shunt. Normal pressure hydrocephalus is characterized by a triad of symptoms: gait disturbance, cognitive impairment, and urinary incontinence, along with ventricular enlargement despite normal intracranial pressure. The VP shunt works by diverting excess cerebrospinal fluid (CSF) from the ventricles of the brain to the peritoneal cavity, which helps to alleviate symptoms by reducing ventricular size and restoring normal CSF dynamics.

Other treatment modalities, such as cognitive therapy, medication, or physical therapy, may be part of a comprehensive care approach, but they do not address the underlying cause of the condition, which is the excess accumulation of CSF. These therapies can help manage symptoms or improve function but are not curative. Thus, the definitive treatment that directly targets the etiology of normal pressure hydrocephalus is the surgical placement of a VP shunt.