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Updated: Sep 1, 2025

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Published on: October 14, 2022
Normal pressure hydrocephalus: an update
Carlos Eduardo Borges Passos-Neto1, Cesar Castello Branco Lopes1, Mauricio Silva Teixeira1
1Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, Grupo de Neurologia Cognitiva e do Comportamento, São Paulo - SP, Brazil.
Normal pressure hydrocephalus (NPH) is a debated condition in the elderly, causing gait, urinary, and cognitive issues. Careful diagnosis and the tap test aid in selecting patients for potentially reversible shunt treatment.
Area of Science:
- Neurology
- Neurosurgery
- Geriatrics
Background:
- Normal pressure hydrocephalus (NPH) is a clinical-radiological syndrome.
- It disproportionately affects the elderly population.
- NPH presents with a triad of gait disturbance, urinary urge incontinence, and cognitive decline.
Purpose of the Study:
- To provide a didactic review of recent literature on NPH.
- To aid in the clinical diagnosis and management of NPH.
- To improve patient selection for ventricular shunt treatment.
Main Methods:
- This study is a narrative review of recent scientific literature.
- It compiles data relevant to clinical practice.
- Focuses on diagnostic criteria and therapeutic response predictors.
Main Results:
- NPH diagnosis requires careful clinical and radiological correlation.
- The tap test is a valuable predictor of shunt treatment response.
- A negative tap test does not preclude potential treatment benefits.
Conclusions:
- Accurate diagnosis is crucial for effective NPH management.
- Symptoms of NPH are potentially reversible with timely intervention.
- Continued research is vital for a comprehensive understanding of NPH.
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