What is normal pressure hydrocephalus? Billy Joel’s brain disorder diagnosis explained

Billy Joel is being treated for a rare brain disorder that has led to him cancelling all upcoming performances and tour dates.

The “Piano Man” star, 76, shared a statement to his official Instagram account that revealed he has been diagnosed with Normal Pressure Hydrocephalus (NPH).

“This condition has been exacerbated by recent concert performances, leading to problems with hearing, vision and balance,” the statement said.

“Under his doctor’s instructions, Billy is undergoing specific physical therapy and has been advised to refrain from performing during this recovery period. Billy is thankful for the excellent care he is receiving and is fully committed to prioritising his health.”

“He is grateful for the support from fans during this time and looks forward to the day when he can once again take the stage.”

What is Normal Pressure Hydrocephalus?

NPH is a condition caused by excess cerebrospinal fluid building up in the brain’s ventricles, which leads to increased pressure that compresses brain tissue and can lead to neurological symptoms.

It is described by the NHS as an uncommon and poorly understood condition that typically affects people over the age of 60.

What are the symptoms?

The damage to the brain caused by hydrocephalus can cause a wide range of symptoms, including headaches, being sick, blurred vision and difficulty walking. Different kinds of hydrocephalus can cause specific symptoms.

The NHS describes the three main types of hydrocephalus as follows:

Normal Pressure Hydrocephalus can sometimes develop after an injury or stroke, but in most cases the cause is unknown.

According to the Cleveland Clinic, NPH affects around 5.9 per cent of people over 80.

Patients are often diagnosed after they see a doctor because they or a family member are concerned they might be developing dementia, as the symptoms – from memory loss, bladder control issues and trouble walking – can be similar.

What causes hydrocephalus?

The NHS explains that the brain is surrounded by a fluid called cerebrospinal fluid (CSF), which has three important functions: to protect the brain from damage, to remove waste products from the brain, and to provide the brain with the nutrients it needs to function properly.

The brain constantly produces new CSF equivalent to around a pint a day, while old fluid is released and absorbed into the blood vessels.

However, if this process is interrupted, the level of CSF can build up and cause pressure in the brain.

How is it treated?

While NPH can present as dementia, it is treatable and often reversible provided it is caught early.

To relieve pressure on the brain, neurosurgeons perform a surgery that involves drilling a hole into the skull and inserting a thin tube (shunt) that drains away the excess fluid.

It has not been disclosed how Joel is being treated, but his statement said he was undergoing “specific physical therapy”.

His fans, friends and family including his daughter Alexa Ray Joel and ex-wife Christie Brinkley are among those to send messages of support to the renowned singer-songwriter.