DEAR DR. ROACH: I have normal pressure hydrocephalus (NPH) and had a spinal tap a few months ago. It helped my brain fog, but my neurosurgeon didn’t want to put in a shunt. I am 96. Can repeated taps help me?

— M.G.

ANSWER: NPH is a condition where the fluid inside the brain has a high pressure. It is unknown why this happens, but symptoms include an abnormal gait and incontinence along with the brain fog you mentioned.

When NPH is suspected, a spinal tap is a useful diagnostic test. Taking a lot of spinal fluid out, which suspends the brain and spinal cord, will temporarily lower the pressure, and if a person’s symptoms (especially their walk) get immediately better, this is a strong sign that the diagnosis is NPH.

Unfortunately the pressure builds back up within a few days, so the cu

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