Billy Joel, 76, revealed on Friday that he is bending over his tour in 2025 because he was diagnosed with the condition of the hydrocephalus brain with normal pressure (NPH).
Joel said his symptoms were exacerbated by his latest direct performances, “leading to problems with hearing, vision and balance.”
He was advised by his doctor to refrain from performance while he undergoes treatment and takes time to recover.
The “New York State of Mind” singer pushed several tour date dates in March because of a “medical condition” that forced him to “suffer physical therapy under the supervision of his doctors” after a fall on stage in February.
“I am sincerely sorry for disappointing our audience and thanking you for their understanding,” Joel said in response to the last round of cancellations.
What is NPH?
NPH occurs when the construction of cerebrospinal fluid (CSF) inside or around the brain disrupts cognitive function.
CSF provides nutrients and removes waste products from the brain while gluing the brain and spinal cord from the force. Typically, adults have five CSF fluid ounces, with the body that produces constantly, circulates and reabsorbs the fluid to maintain that level constant.
However, when the body fails to circulate or reabsorb CSF correctly, the fluid can accumulate.
Typically, this construction is quite gradual for the pressure inside the skull to increase, but stays within the normal range, and the fluid goes into the brain’s ventricles, which can hold some of the overflows.
However, if the CSF continues to collect, the brain begins to include, and if this compression lasts long, it can cause permanent damage.
NPH is more common in the elderly, with average age of diagnosis 70.
NPH affects about 0.2% of people between the ages of 70 and 80, and about 5.9% of people over 80. NPH is very rare in people under 65, affecting only about 0.003% of people in that demographic.
What are the symptoms?
NPH symptoms gradually begin and worsen for three to six months. The three main symptoms are known as triads of hacim and include:
- Urinary incontinence.
- Hiking
- Cognitive difficulties, including memory issues and emotional changes.
Between 50% and 75% of people with NPH show all three symptoms at the same time.
While the symptoms of NPH are similar to those experienced by patients with dementia, NPH is, in some cases, reversible.
What causes nph
There are two forms of NPH, primary (idiopathic) NPH and secondary NPH. Joel has not revealed the first form of NPH from which it suffers.
NPH’s primary accounts for half of all cases and attributed to realized issues that compromise the body’s ability to make, circulate and reabsorb CSF.
The evidence also suggests that the NPH may be related to the degenerative conditions of the brain such as Alzheimer’s disease and other forms of demntia. About 30% of people with NPH also have Alzheimer’s disease or a similar degenerative brain disease, according to the Cleveland Clinic.
Secondary NPH is characterized by a basic medical condition that affects the body’s ability to regulate CSF. These conditions include aneurysms and brain tumors, infections such as encephalitis or meningitis, stroke and/or traumatic brain damage.
How is NPH diagnosed
Due to the overlap between the symptoms of dementia and the NPH, the diagnosis of the conditon is difficult.
The NPH is typically diagnosed by eliminating other possibilities and using a combination of methods including spine, physical and neurological examination, and diagnostic image. MRI scans are the most important tool in the NPH diagnosis.
How is NPH treated
Unlike other conditions similar to dementia, in some cases NPH is reversible.
The primary nph is typically treated with an operation and the implementation of a Shunt. Shunt is characterized by two catheters that allow excess fluid to emerge.
During surgery, a small hole is made in the skull and Catherter passes even though it, coming down and allowing CSF to dry in the chest or abdomen, where it can be absorbed.
The type and efficiency of secondary treatment NPH depends on the underlying cause.
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Image Source : nypost.com