NORMAL PRESSURE hydrocephalus (NPH) is characterized by the clinical triad of gait disorder, cognitive dysfunction, and incontinence associated with ventriculomegaly and normal cerebrospinal fluid (CSF) opening pressure.1,2 This syndrome is difficult to differentiate from subcortical arteriosclerotic encephalopathy, which is far more commonly the source of the clinical triad. Although ventricular shunting of NPH is effective in halting progression and reversing deficits in some patients, treatment failures abound. Treatment failures are in part attributable to faulty selection of patients and/or suboptimal shunting techniques. In this issue of the ARCHIVES, Bergsneider et al3 help to refocus attention on some of the important issues in treatment of adult patients with NPH.
Pleasure SJ, Fishman RA. Ventricular Volume and Transmural Pressure Gradient in Normal Pressure Hydrocephalus. Arch Neurol. 1999;56(10):1199-1200. doi:10.1001/archneur.56.10.1199