The Virginia General Assembly recently honored Harold F. Young, M.D., chairman of the Department of Neurosurgery, and Anthony Marmarou, Ph.D., director of Research for the Department of Neurosurgery at Virginia Commonwealth University's Medical College of Virginia Hospitals, for their work in the diagnosis and treatment of normal hydrocephalus. Drs. Young and Marmarou are developing a brochure to increase public awareness about NPH to be mass distributed in Virginia. The State has called for an epidemiologic survey of the elderly population in Virginia extended care facilities in order to identify the number of patients with suspected NPH who could benefit from medical therapy. The study will be completed in one year and the results reported to the legislature. Once an epidemiological signature has been established, the American Brain Injury Consortium, which is located in Richmond, VA and consists of over 250 neurosurgical centers in the U.S. and Canada, will coordinate a nationwide project.

Normal Hydrocephalus (N.P.H.) is a problematic condition that develops in older people as a result of an abnormal accumulation of cerebrospinal fluid in the ventricles of the brain. N.P.H. is a condition that is often underdiagnosed because its symptoms, which are urinary incontinence, progressive dementia and unsteady gait, are often mistaken for senility. Using a computerized mathematical model developed by Dr. Marmarou, VCU physicians are able to determine whether the patient has a cerebrospinal fluid absorption problem. This diagnostic tool coupled with the external draining of excess fluid over a three day period tells doctors whether a patient will benefit from surgical intervention. As with many diseases, early detection of this condition can lead to effective treatment. Often patients are diagnosed with NPH several years after their condition has progressed to a point where surgical intervention would not promote recovery. If detected at at an early stage, NPH can be treated surgically by placing a shunt or valve into the ventricle and draining the excess cerebrospinal fluid into the peritoneal cavity or belly where it will be absorbed. With the FDA approval of the adjustable shunt, neurosurgeons at VCU can adjust the pressure used to drain the excess fluid externally; thus, eliminating the need for multiple operations. Drs. Young and Marmarou are seeing amazing results with this diagnosis and treatment method. Many patients assumed to be senile are now leading healthy, productive, independent lives.

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Maintained by: Andrew Beaumont MD

Department of Neurosurgery
Updated August 2003, Rev 4.0