The brain damage that forced Billy Joel to cancel a concert tour can be a challenge to walk or think straight, but it is often treatable and even reversed, doctors said.
A 76-year-old singer's Instagram post on Friday said he was recently diagnosed with normal pressure hydrocephalus and that his concert performance exacerbated his “hearing, vision, and balance” issues.
According to the Cleveland Clinic, the condition is relatively rare and affects “about 5.9% of people over the age of 80.”
It is most commonly diagnosed in older people and usually appears around the age of 70.
What is normal pressure hydrocephalus?
The human body is constantly trying to maintain stable levels of cerebrospinal fluid in order to relieve the brain and spinal cord by making or absorbing more.
Dr. Wajd Al-Holou, a health neurosurgeon at the University of Michigan, said that the fluid tends to take up a little more space in the elderly as the brain volume shrinks as a normal part of the aging process.
“But hydrocephalus, which occurs at normal pressure, is an abnormal accumulation of fluids that cause brain dysfunction due to pressure on the brain,” he said.
What are the symptoms and how is it diagnosed?
Patients are often diagnosed after seeing a doctor. Because they are concerned that or their family may develop dementia.
Amnesia, bladder control problems, and walking difficulties are also common. Patients may have difficulty lifting their feet and may be at risk of tripping or falling.
Doctors often learn about normal pressure hydrocephalus and its three distinctive symptoms, Dr. Vikram Udami, a neurosurgeon in private practice in San Diego, through this catchphrase.
“'Strange' stands for walking instability, such as cognitive issues, usually memory issues or confusion,” he said. “Wet” means urinary incontinence. ”
Brain imaging, either CT scans or MRI, is commonly used to search for fluid accumulation, as well as various neural tests.
Doctors may also do what is called a lumbar puncture to drain excess fluid. If the person's symptoms improve, the condition is often diagnosed as normal pressure hydrocephalus, or NPH.
Mudami said he didn't know what caused the condition, but added that it's very unlikely that loud music or concert tours will cause NPH.
How will it be treated?
It can look like dementia, but there are important differences. Normal pressure hydrocephalus is treatable and is often reversible if caught early.
Generally, neurosurgeons plant ventricular dysfunctional shunts or tubes in the brain that helps to drain fluid buildup in other parts of the body, such as the abdomen. The patient then essentially pees with excess fluid, Udami said.
Drugs called acetazolamides can also be used. This is because it can help the body reduce fluid levels on its own. Drugs don't work for anyone, Al Hollow said.
It was unclear what kind of treatment Joel would receive on Friday. His social media post said the singer was “in undergoing certain physical therapy,” but did not provide details.
This type of treatment is usually given to help patients get back to balance, doctors said.
Treatment is more effective when the diagnosis is made quickly. If conditions are not checked too long, it can lead to permanent brain damage, Al Horu said.
If a person appears to be experiencing early signs such as troublesome memory loss or difficulty walking, he said, “they should look at a primary care physician or neurologist to investigate further.”