It is the condition that an estimated 700,000 Americans affects, but is often mistaken for dementia, Alzheimer’s or Parkinson’s.
And it can be linked to a rather head injury or trauma.
Nevertheless, the normal pressure hydrocephalus is a condition that doctors can treat, especially when they are diagnosed in diagnosed to prevent long-term effects.
Billy Joel today revealed that he suffered from the condition, in an abrupt announcement in which the 76-year-old also canceled his upcoming concerts.
A spokesperson for the singer said that his condition was ‘exacerbated’ by recent versions, which led to problems with hearing, vision and balance. He now takes a break and undergoes ‘physiotherapy’ to treat the condition.
Normal pressure hydrocephalus is caused by collecting too much liquid in the ventricles, or spaces in the brain and spinal cord, exert pressure in these areas and activating the symptoms, including wrestles to walk, an inability to control bladder and memory problems.
This happens because the excess liquid compresses and extends the brain tissue, thereby disturbed the control of muscles and communication between nerve cells.
Dr. Matt Potts, a neurosurgeon at Northwestern University who has treated hundreds of patients with the disease, told DailyMail.com that it is initially often diagnosed incorrectly – with many patients, normally in their 1970s, in the first place treated for other diseases.
Billy Joel has revealed that the diagnosis of normal pressure hydrocephalus has been diagnosed. He is shown above on stage in February 2025 in Connecticut during his last concert before he announces the diagnosis
In normal pressure hydrocephalus, liquid gathered in the ventricles in the brain – or the spaces in the brain – that exert more pressure. However, the condition does not cause an increase in brain pressure
“The challenge with this condition is that in older people who can have things for many different reasons,” he said.
‘It can absolutely be seen for dementia, for example, or another more usual condition – patients who are waiting for treatment for more than a year. In some cases it is never diagnosed. ‘
Joel’s last concert took place in the Mohegan Sun Arena in Uncasville, Connecticut, on February 22 this year.
It is not clear what the condition causes, but earlier cases have also seen that it is linked to brain bleeding, infections and rather surgery on the brain or a tumor in that area.
It is rarely fatal, but if it remains untreated, it can lead to further complications due to damage to the brain.
These may be that someone loses the ability to walk or have more and more serious memory problems.
What is normal pressure hydrocephalus?
Normal pressure hydrocephalus, or NPH, is a condition that takes place where cerebrospinal fluid builds up in the skull and exerts pressure on the brain.
The brain contains ventricles or cavities, filled with liquid used to dampen the organ and spinal cord – causing damage.
Normally the body makes just enough fluid for these areas – called cerebrospinal liquid – and absorbs the same amount every day.
But in rare cases too much liquid can build up in the ventricles – put pressure on the organ and activate the warning signals of the condition.
Is it becoming increasingly common?
The condition is considered rare, but is often diagnosed incorrectly.
Yale Medicine Says that although estimates suggest that there are no fewer than 700,000 Americans suffering from the condition – less than 20 percent actually know that they have it.
The error can lead to delays in getting good treatment, which increases the risk of a patient that suffers permanent damage to their brain.
Joel has abruptly canceled all his upcoming versions and said that he must concentrate on his health (shown above in October 2021)
Dr. Potts said that patients often have to wait at least a year to finally get a diagnosis, and often much longer. In some cases, he said, the condition is never diagnosed.
The condition does not cause pressure in the brain, but can still be detected on brain scans that show enlarged ventricles.
It differs from the form of Hydrocephalus that more often affects children, which leads to much higher pressure levels in the brain than normal.
What are the warning signals?
Dr. Potts said there were three main warning signals for the disease: memory problems, walking or balance problems and problems with urination.
For movement, signs of the state include problems to take the feet, short or unstable steps, to rotate toes outside while walking, freezing or walking insecure.
For bladder issues, doctors say that losing control over the bladder is a signal, whereby this ensures that someone unintentionally urinates.
And for cognitive issues, signs of the condition are slower than normal, having problems with memory or seem to be forgetful or absent.
Patients can also have problems managing their emotions, or may seem to be apathetic or not interested in activities they used to enjoy.
According to some studies, it can also cause hearing problems – which have found a connection between the condition and this complication. Doctors believe that this is due to changes in the liquid pressure that influence the inner ear.
How likely are you to survive the condition?
Studies suggest That patients survive on average 8.8 years after their diagnosis, with a quarter more than 13 years.
Patients are normally also diagnosed around the age of 70, doctors say.
Dr. Potts emphasized that a diagnosis with the condition was not considered a death sentence, but something that can be treated.
He said: ‘If it is not treated, it usually progresses, but that progression can be very, very slow.
‘Normal pressure hydrocephalus in itself will probably not be fatal, but if it progresses in an extreme way, someone can no longer walk.
“In itself, however, we do not consider it a fatal condition.”
The condition can be treated by inserting a device to gradually remove liquid from the brain
How is it diagnosed?
Normal pressure hydrocephalus is diagnosed through a combination of neurological and physical exams.
These can include an MRI scan to reveal the ventricles in the brain and show whether they are being expanded – which indicates a higher pressure and can be a sign of the condition.
Patients can also be tested for the disease using a spinal tap, which samples cerebrospinal liquid for signs of the condition.
Dr. Potts said that the diagnosis often comes years after the symptoms, which first appear, saying that it takes time for patients to seek help and then for care providers to make the right diagnosis.
How is it treated?
Normal pressure hydrocephalus is treated by relieving the excess liquid that causes pressure on the brain.
This can be done through an operation to place a tube, called a shunt, in the brain to tap excess fluid.
The shunt is normally placed in a ventricle in the brain and then placed under the skin of your head through the neck and to the chest to your stomach.
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