The 76 -year -old Billy Joel, Billy Joel, said that he was leaning on his 2025 tour after being diagnosed with the brain condition of normal pressure hydrocephalus (NPH).
Recent live performances “lead to problems with hearing, vision and balance,” Joel told Instagram.
His doctor advised him to refrain from performing while undergoing treatment and recovery.
The interpreter “New York Mood” postponed several tour dates in March due to a “medical condition” that forced him to “undergo physical therapy under the supervision of his doctors” after a fall on stage in February.
“I am sorry to disappoint our audience and thank you for understanding,” Joel said on Friday in response to the last round of cancellations.
What is NPH?
Hydrocephaly occurs when cephalorraquid fluid (CSF) accumulates in the brain, disturbing cognitive functioning.
The CSF provides nutrients and eliminates the waste from the brain while also cushioning and the spinal cord of force.
Typically, adults have 5 ounces of CSF fluids, with the body that constantly produces, circulating and reabsorbs the fluid to maintain this constant level.
But when the body does not circulate or reabsorb CSF correctly, it can accumulate.
In the NPH, this accumulation is usually gradual enough that the pressure inside the skull increases, but remains within the normal range. The liquid enters the ventricles of the brain, which may contain part of the overflow.
“NPH is a type of hydrocephaly that is usually seen in the elderly,” said Dr. Matthew Potts, an associate professor of neurological surgery, radiology and neurology at Northwestern University Feinberg School of Medicine, in The Post.
“The fluid accumulates and does not necessarily affect the pressure in the brain, therefore the part of” normal pressure “, but it still affects the brain.”
If CSF continues to collect, the brain begins to compress. If this compression lasts too much, permanent damage may occur.
The NPH is more common in the elderly, with the average age of 70 years.
The NPH affects about 0.2% of people between the ages of 70 and 80 and about 6% of people over 80 years old. It is very rare in people under the age of 65.
What are the symptoms?
The symptoms of the NPH begin gradually and worsen for three to six months. The three primary symptoms are known as the Hakim triad and include:
- Urinary incontinence
- Walking difficulty
- Cognitive difficulties, including memory problems and emotional changes
Between 50% and 75% of people with NPH have the three symptoms at once.
“The three classic symptoms of the NPH (cognitive/memory problems, problems with balance/march and urinary incontinence) are very similar to many other things that can happen in greater adults,” said Potts.
“Therefore, some people can be diagnosed with dementia even though it is NPH. If it is caused by NPH, we have a treatment for it.”
What causes the NPH?
There are two forms of NPH: primary (idiopathic) NPH and NPH Secondary. Joel has not revealed the NPH form he has.
Primary NPH accounts for half of all cases and is attributed to age issues that compromise the body’s ability to make, circulate and reabsorb the CSF.
Evidence suggests that the NPH may be connected to degenerative brain conditions such as Alzheimer’s disease and other forms of dementia. About 30% of NPH people also have Alzheimer’s or a similar condition, according to Cleveland Clinic.
Secondary NPH is characterized by an underlying medical condition that affects the capacity of the body to regulate the CSF. These conditions include brain aneurysms and tumors, infections such as encephalitis or meningitis, stroke and/or traumatic brain injuries.
How is NPH diagnosed?
NPH is a worsening condition that affects cognition, which means that many people do not know that they have it. This hinders early detection and early treatment.
Due to the overlap between symptoms of dementia and NPH, the diagnosis of the NPH is a challenge.
Doctors often eliminate other possibilities by means of a combination of methods, including spinal tap, physical and neurological examination and diagnostic image.
“There is no proof that says” Yes, this is NPH. “For some patients, the liquid will be built and a brain exploration (TC or RMN) can be displayed, but that does not mean that it is NPH,” said Potts.
“Ultimately, is it about making the symptoms really fit with the doctors of the image?”
How is NPH treated?
Primary NPH is normally treated with surgery and the implementation of a shunt. One of the ends of the Shunt enters the CSF, while the other end usually goes to the abdomen to drain excess fluid.
Potts said that neurosurgeon often did a test that simulated what would happen if they drain the liquid.
“We place a needle on the bottom of the back to drain the liquid (called a lumbar puncture or spinal tap), which acts as a small temporary drainage that helps the liquid slowly out of the body through its skin for a few days to simulate if they had a discomfort,” he added.
“We ask ourselves: I get better? If there are more than a few days their balance and gait, we say, if we put a shunt, you will probably improve. If not, we say maybe it will not be NPH.”
The type and efficiency of NPH secondary treatment depend on the underlying cause.
NPH prognosis
Unlike other conditions similar to dementia, NPV is often reversible, with a positive prognosis linked to diagnosis and early treatment.
The longer NPH is not diagnosed, the more likely to increase the pressure, serious or permanent brain damage will cause.
With the treatment, the three symptoms of the NPH; Mobility problems, cognitive difficulties and urinary incontinence are likely to improve.
Factors that positively influence the result of treatment include early diagnosis, the NPH that improves after CSF is eliminated during a spinal tap and cognitive problems that are presented after mobility and incontinence.
For its part, delayed diagnosis, cognitive difficulty of early onset and the presence of other degenerative brain conditions make a positive prognosis less likely.
#normal #pressure #pressure #NPH #brain #condition #affects #Billy #Joel
Image Source : nypost.com