What is normal pressure hydrocephalus (NPH)? All about the brain condition affecting Billy Joel
Billy Joel, 76, said Friday that he is bowing out of his 2025 tour because he has been diagnosed with normal pressure hydrocephalus (NPH).Joel said on Instagram that his brain condition had been exacerbated by his recent live performances, “leading to problems with hearing, vision and balance.”He was advised by his doctor to refrain from performing while he undergoes treatment and takes time to recover.The “New York State of Mind” singer postponed several tour dates in March due to a “medical condition” that forced him to “undergo physical therapy under the supervision of his doctors” following an onstage fall in February.“I’m sincerely sorry to disappoint our audience, and thank you for understanding,” Joel said Friday in response to the latest round of cancellations.NPH occurs when cerebrospinal fluid (CSF) builds up inside or around the brain, disrupting cognitive functioning.CSF provides nutrients to and removes waste products from the brain while cushioning it and the spinal cord from force.Typically, adults have 5 fluid ounces of CSF, with the body constantly producing, circulating and reabsorbing the fluid to keep that level constant.But when the body fails to circulate or reabsorb CSF correctly, it can accumulate.This buildup is usually gradual enough that the pressure inside the skull increases, but stays within normal range, and the fluid runs into the brain’s ventricles, which can hold some of the overflow.Yet, if CSF keeps collecting, the brain begins to compress.If this compression lasts too long, permanent damage can occur.NPH is most common in seniors, with the average age of diagnosis being 70.
NPH affects about 0.2% of people between the ages of 70 and 80 and about 6% of people over 80.NPH is very rare in people under 65, only affecting about 0.003%.NPH symptoms begin gradually and worsen over the course of three to six months.
The three primary symptoms are known as Hakim’s triad and include: Between 50% and 75% of peopl...