Billy Joel has canceled his concert tour due to a little-known medical condition called normal pressure hydrocephalus (NPH), but doctors say the condition is treatable and the 76-year-old singer has no plans to retire.
Fans of the “Piano Man” can breathe a sigh of relief: with proper medical care, Joel is expected to recover well, and specialists say the same holds true for many who suffer from NPH.
“At St. Luke’s Center for Neuroscience, we have extensive experience treating normal pressure hydrocephalus,” said Dr. Craig Goldberg, a neurosurgeon at the center.
NPH is a condition typically seen in older adults in which cerebrospinal fluid (CSF) builds up in the brain without increasing pressure. The fluid, which surrounds the brain and spinal cord, fails to drain properly, leading to symptoms that can include problems with balance, vision and hearing.
The condition most often occurs in people over age 70, affecting approximately 0.2% of people between ages 70 and 80, and up to 5.9% of those over 80. Risk factors include brain infections, injuries, tumors or prior brain surgery.
Dr. Goldberg outlined the three primary symptoms of NPH:
- Difficulty walking with shuffling, wide-based steps
- Urinary urgency or incontinence
- Mild dementia marked by forgetfulness and difficulty completing routine tasks
“Since there are many possible causes for these symptoms, your care team at St. Luke’s will take a detailed history, perform a thorough physical exam and ask specific questions about your experience,” Goldberg said.
An MRI is typically used to rule out other diagnoses. If symptoms are mild, doctors may monitor the condition before proceeding with further testing.
To help confirm a diagnosis, patients may undergo cognitive and physical testing before and after a lumbar puncture, or spinal tap, which removes CSF from the lower back.
If treatment is necessary, surgery can involve placing a ventriculoperitoneal shunt—a drainage tube that diverts excess fluid from the brain to the abdomen.
Goldberg noted that early diagnosis and treatment often lead to significant improvements in mobility, cognitive function and quality of life.
