Evidence map›Paper›PMID 42423145›Full record

ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2026

Current practice patterns among Indian neurologists in the Evaluation and management of Normal Pressure Hydrocephalus: A nationwide cross-sectional survey.

Arunmozhimaran Elavarasi, Sagar Poudel, Deepa Dash, Alfonso Fasano, Pramod Pal, Debashish Chowdhury, Sanjay Pandey, Soaham Desai, Hrishikesh Kumar, Prashant Lingappa Kukkle and 13 more

Abstract read
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In one paragraph

Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Arunmozhimaran ElavarasiDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.ORCID https://orcid.org/0000-0002-0128-7037
Sagar PoudelDepartment of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Deepa DashDepartment of Clinical Neurological Sciences, University of Western Ontario, London, Canada.
Alfonso FasanoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Pramod PalDepartment of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India.
Debashish ChowdhuryDepartment of Neurology, GB Pant Institute of Medical Education and Research, New Delhi, India.
Sanjay PandeyDepartment of Neurology, Amrita Institute of Medical Sciences, Delhi NCR, India.
Soaham DesaiDepartment of Neurology, Pramukhswami Medical College, Karamsad, India.
Hrishikesh KumarMovement Disorders Program, Institute of Neurosciences, Kolkata, India.
Prashant Lingappa KukkleParkinson's Disease and Movement Disorders Clinic, Bengaluru, India.
Divya KpDepartment of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Ajith CherianDepartment of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
Rajeswari ADepartment of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Rukmini MridulaParkinson's disease and Movement disorders Research Center, Yashoda Hospital, Hyderabad, India.
Pankaj AgarwalMovement Disorders, Gleneagles Hospitals, Mumbai, India.
Niraj KumarDepartment of Neurology, All India Institute of Medical Sciences, Bibinagar, India.
Anand KumarDepartment of Neurology, Banaras Hindu University, Banaras, India.
Saranya GomathyDepartment of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Animesh DasDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Rajesh Kumar SinghDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Deepti VibhaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Jasmine PariharDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Manjari TripathiDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis cross-sectional study explores the diagnostic and management practices of normal pressure hydrocephalus (NPH) in India.

methodsA 16-question online survey based on the Checklist for Reporting Results of Internet E-Surveys checklist was disseminated via closed social media and academic groups.

resultsA total of 59 neurologists responded. There was significant variability in how the cerebrospinal fluid (CSF) tap test (TT) was implemented. Although 95% of practitioners performed a CSF TT before referring patients for surgery, there were differences in the volume of CSF removed, the assessment tools used, thresholds, and the timing of post-test evaluations. Notably, 36% of neurologists relied on subjective assessment instead of objective scoring to determine CSF TT responsiveness. One-third still considered surgical referral even if the CSF TT was negative, especially when imaging was strongly suggestive of the diagnosis.

conclusionThis study highlights considerable heterogeneity in the evaluation of NPH in India. We need evidence-based practice parameters to ensure accurate diagnosis, informed treatment decisions, and improved patient outcomes.

Indexed as

Hydrocephalus, Normal PressureNeurologistsPractice Patterns, Physicians'Cross-Sectional StudiesHumansIndiaMaleSpinal PunctureSurveys and QuestionnairesCSF tap testidiopathic normal pressure hydrocephaluspractice patternssurvey

Identifiers

PMID42423145
PMCPMC13347313

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LicenceCC BY-NC-ND
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Registered trials

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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.