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 around 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% to 75% of people with NPH they simultaneously have all three symptoms.
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 suffers.
Accelerate of the primary NPH for half of all cases and is attributed to problems that were made with the age that compromise the body’s ability to make, circulate and reabsorb the CSF.
Evidence also suggests that the NPH may be connected to degenerative brain conditions such as Alzheimer’s disease and other forms of Demntia. About 30% of NPH people also have Alzheimer’s disease or similar degenerative brain disease, 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 NPH is diagnosed
Due to the overlap between dementia and NPH symbols, the diagnosis of the condition is difficult.
NPH is usually diagnosed by eliminating other possibilities and through a combination of methods that include spinal cord, physical and neurological examination and diagnostic images. MRI explores are the most important tool in the diagnosis of the NPH.
How is NPH treated
Unlike other conditions similar to dementia, in some cases the NPH is reversible.
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 Catherter passes, although, going down and allowing the CSF to drain on the chest or the abdomen where it can be absorbed.
The type and effectiveness of the NPH secondary treatment depends on the underlying cause.
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Image Source : nypost.com