neurologic disorders
Normal–Pressure Hydrocephalus
Key Points
Suspect normal-pressure hydrocephalus based on classic symptoms (gait disturbance, urinary incontinence, dementia), but consider lumbar puncture to remove excess CSF as a diagnostic trial to help confirm the diagnosis. If surgical risks are acceptable, insert a ventriculoperitoneal shunt, which may significantly improve gait, continence, and daily functioning; improvement in mental function is less. 