Billy Joel, 76, said on Friday that he leaned on the 2025 tour because he was diagnosed with a normal pressure hydrocephaly (NPH).
Joel told Instagram that his brain condition had aggravated his recent live performances, “which has problems with hearing, vision and balance.”
His doctor advised him to refrain from performing while undergoing treatment and needing time to recover.
The singer “New York State” 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?
The NPH occurs when the cephalorrachid fluid (CSF) accumulates inside or around the brain, disrupting 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.
This accumulation is usually gradual enough that the pressure inside the skull increases, but remains within the normal range and the liquid is in the ventricles in the brain, which may contain part of the overflow.
However, 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. The NPH is very rare in people under 65, it only affects around 0.003%.
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.
Although NPH symptoms are similar to those experienced by dementia patients, the NPH is, in some cases, reversible.
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 also suggests that the NPH can 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?
The NPH is a worsening condition that affects cognition, which means that many people do not know that they have it, which makes it difficult to detect early 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. MRI explores are the most important tool in the diagnosis of the NPH.
How is NPH treated?
Primary NPH is normally treated with surgery and the implementation of a shunt. The Shunt is characterized by two catheters that allow you to leave with excess fluid.
During the surgery, a small hole is made in the skull and the catheter goes through it, going down and allowing the CSF to drain to the chest or the abdomen, where it can be absorbed.
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.
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Image Source : nypost.com