Common Conditions
Alabama Neurosurgeons provides the most advanced treatment for conditions of the brain, spine and nerves. Below you will find more information about several conditions we treat.
SpondylolisthesisNormal Pressure Hydrocephalus
Low Back Pain
Sciatica
Slipped Disc
One of the treatable causes of dementia (or difficulty thinking) is NPH, or normal pressure hydrocephalus. Inside the brain are cavities where the spinal fluid is made, these are called ventricles, at times they can be enlarged. Frequently, they are enlarged because of increased pressure in the brain. However, at times, they enlarge without this accompanying pressure at least on a constant basis, and this can result in a triad of symptoms:
- Dementia or difficulty thinking. Recent memory may be affected first.
- Difficulty ambulating. A magnetic gait is noted where the patient seems to be adherent to the floor, yet can sometimes walk fairly well with merely guidance holding a patient's fingertips (as opposed to complete support of the patient’s body) in order to ambulate. Great difficulty rising from a chair is frequently noted.
- Incontinence of urine. Losing a small amount of urine is frequent as we get older, especially in women, but serious loss of urine, can suggest the third leg of this triad of symptoms.
Not all 3 complaints are necessary for this diagnosis to made. There are pros and cons as to the various diagnostic techniques utilized to confirm this diagnosis. None are completely without problems.
An MRI scan and CAT scan can give a good idea as to the diagnosis especially when accompanied by the appropriate symptoms. At times, drainage of the spinal fluid in the hospital over several days can be useful in determining whether or not a shunt procedure may be helpful in treating this condition. There are increased risks for infection, including meningitis and there still may still be some error with this technique. A radionuclide cisternogram is a study performed with a radionuclide or radioactive material, to determine if the spinal fluid flow is abnormal. Used for decades to assist in making this diagnosis, recent literature suggests the usefulness of this technique is very limited.
Once the diagnosis of NPH is made, a shunt may be considered. This is a small tube, which is placed into the ventricles of the brain and brought beneath the skin, to the abdominal cavity, where the fluid is absorbed.
Some patients can report a remarkable response in reduction of symptoms. It truly is one of the few treatable causes of dementia commonly seen.
Newer techniques with adjustable valves (also, placed below the skin), make the “fine tuning” of spinal fluid regulation safer and more predictable.
Adjustment can be done after surgery in the doctor’s office without intervention, using a small magnetic instrument that calibrates the internal device. Please see the video on the treatment of normal pressure hydrocephalus patient below.
 View the Normal Pressure Hydrocephalus presentation |
Subaracnoid Hemorrhage
Mechanical Disorders and Disc Herniation
Inflammatory & Infectious Disorders
Tumors of the Spine and Spinal Cord
Neck Trauma
Herniated Disc and Arthritis
Mechanical Disorders
Inflammatory & Infectious Disorders
Back Truama
Osteoporosis
Carpal Tunnel Syndrome
Cubital Tunnel Syndrome