ReviewDeutsches Arzteblatt international2012
The differential diagnosis and treatment of normal-pressure hydrocephalus.
Review in Deutsches Arzteblatt international, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 55 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Identifying Gait Changes From a Cerebrospinal Fluid Tap Test Using a Smart Insole in Idiopathic Normal Pressure Hydrocephalus
The Role of the Glymphatic System Avaluated Thourgh mr Imaging in the Diagnosis and Management of NPH
Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effect of magnetic interference by magnetic resonance imaging on programmable shunt valves in patients with normal pressure hydrocephalus: a systematic review and pooled analysis.Fluids and barriers of the CNS · 2026Pooled it
- Perioperative real-life mobility assessment using wearable step counts in idiopathic normal pressure hydrocephalus after ventriculoperitoneal shunt surgery: a prospective pilot study.Neurosurgical review · 2026Article
- Beyond Hakim's triad: a systematic review of atypical clinical manifestations in idiopathic normal pressure hydrocephalus.Acta neurologica Belgica · 2026Review
- Minimizing complications in lumboperitoneal shunt for normal pressure hydrocephalus: Technical note and case series.Surgical neurology international · 2026Article
- Stratified screening-based cognitive measures reveals temporal patterns of recovery after the CSF tap test in idiopathic normal pressure hydrocephalus (iNPH): A single-centre retrospective study.Therapeutic advances in neurological disorders · 2026Article
- Automatic coarse-to-fine AC-PC localization on CT using registration-guided 3D-UNets.Frontiers in neuroinformatics · 2026Article
- Neuropsychiatric Clues to Herpes Simplex Virus Encephalitis Presenting as Normal Pressure Hydrocephalus.Case reports in psychiatry · 2026Article
- Cerebrospinal-fluid Orexin-A levels in different neurocognitive disorders: a comparison study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Early Presentation and Management of Normal Pressure Hydrocephalus in a Middle-Aged Patient: A Case Report.Cureus · 2025Article
- Using Artificial Neural Network Models (ANNs) to Identify Patients with Idiopathic Normal Pressure Hydrocephalus (INPH) and Alzheimer Dementia (AD): Clinical Psychological Features and Differential Diagnosis.Medicina (Kaunas, Lithuania) · 2025Article
- Splenial angle on axial T1 and fluid-attenuated inversion-recovery MRI images and idiopathic normal pressure hydrocephalus.The British journal of radiology · 2025Article
- Article
- Unbiased CSF Proteomics in Patients With Idiopathic Normal Pressure Hydrocephalus to Identify Molecular Signatures and Candidate Biomarkers.Neurology · 2025Article
- Article
- Regulation of brain fluid volumes and pressures: basic principles, intracranial hypertension, ventriculomegaly and hydrocephalus.Fluids and barriers of the CNS · 2024Review
- Cognitive decline after ventriculoperitoneal shunt surgery for normal pressure hydrocephalus.Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society · 2024Article
- Structural neuroimaging markers of normal pressure hydrocephalus versus Alzheimer's dementia and Parkinson's disease, and hydrocephalus versus atrophy in chronic TBI-a narrative review.Frontiers in neurology · 2024Review
- Idiopathic Normal Pressure Hydrocephalus: The Real Social and Economic Burden of a Possibly Enormous Underdiagnosis Problem.Tomography (Ann Arbor, Mich.) · 2023Article
- Long-term follow-up and comparison of programmable and non-programmable ventricular cerebrospinal fluid shunts among adult patients with different hydrocephalus etiologies: a retrospective cohort study.Acta neurochirurgica · 2023Article
- Idiopathic Normal Pressure Hydrocephalus and Progressive Supranuclear Palsy: Two Single Entities or Neurodegenerative Overlap Syndrome? A Case Report.Medicina (Kaunas, Lithuania) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNormal-pressure hydrocephalus (NPH) arises in adulthood and is characterized by a typical combination of clinical and radiological findings. The mean basal intracranial pressure is normal or mildly elevated. The typical signs of the disease are gait impairment, urinary incontinence, and dementia. The difficulty of distinguishing NPH from other neurodegenerative disorders is the likely reason why some 80% of cases remain unrecognized and untreated. According to current evidence, the spontaneous course of NPH ends, for the vast majority of patients, in dependence on nursing care.
methodsThis review article is based on relevant publications retrieved by a selective search in Medline and on national and international guidelines for the management of NPH.
resultsStudies with a high evidence level are lacking; thus, the current state of knowledge about NPH is derived from studies of low or intermediate evidence levels, e.g., observational studies. Modern forms of treatment lead to clinical improvement in 70% to 90% of treated patients. The treatment of choice is the implantation of a ventriculoperitoneal shunt. The differential diagnosis is complicated by the fact that three-quarters of patients with NPH severe enough to require treatment also suffer from another neurodegenerative disorder. Therefore, the clinical findings and imaging studies often do not suffice to establish the indication for surgery. To do this, a further, semi-invasive diagnostic procedure is recommended. Current risk/benefit analyses indicate that shunt operations improve outcome compared to the spontaneous course of the disease.
conclusionNormal pressure hydrocephalus should always enter into the differential diagnosis of patients who present with its characteristic manifestations. If the diagnosis of NPH is confirmed, it should be treated at an early stage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.