[Normal pressure hydrocephalus--from clinical picture to diagnosis. Help by early shunt placement]

Normal pressure hydrocephalus (NPH), which may either be idiopathic or occur secondarily, is responsible for approximately 6% of the cases of dementional syndromes in the elderly. Although its diagnosis still remains a problem, every attempt should be made to identify patients with clinical symptoms arising from NPH, since the placement of a shunt can result in a much improved quality of life. Candidates for surgical treatment must be selected with care, since the transient peri-operative morbidity may be as high as 7%.